Maternal factors associated with birth asphyxia at the University Teaching Hospitals, Lusaka, Zambia
AbstractBackground: Birth asphyxia is associated with significant perinatal complications. The World health organization (WHO) estimates that 3% of neonates born each year develop asphyxia and need resuscitation (WHO 2016). Because of the paucity of data and enormous magnitude of birth asphyxia, available figures are likely to underestimate the proportion of the problem (WHO 2016). Research is needed to estimate the contribution of birth asphyxia to perinatal morbidity and mortality at the University Teaching Hospital (UTH), Lusaka, Zambia. Methodology: A case control study comprising 72 newborns from labour ward with birth asphyxia (Apgar score <7) (n=72) and 125 well newborn presenting to the postnatal ward and having been delivered within UTH from 1st November 2015 to January 2016 was conducted. A questionnaire was used to collect data along with medical records of the newborn. A multiple logistic regression model was used to assess the association of maternal obstetric conditions and birth asphyxia while controlling for confounders. Results: Of the 197 patients enrolled, 72 had birth asphyxia of which 37 were born with mild birth asphyxia (Apgar score 4-6) while 35 were born with severe birth asphyxia (Apgar score 1-3). Neonates delivered by spontaneous vaginal delivery had 88% reduced odds for birth asphyxia [ Odds Ratio (OR) 0.12, 95% Confidence Interval (CI) 0.05 – O.31, P- value< 0.01]. Neonates with birth weight between 2500-3500g had on average 96% reduced odds ratio for birth asphyxia (OR 0.04, 95% CI 0.02-0.11, P- value < 0.01) compared to neonates with birth weight above 3500g. Compared to newborn of mothers with parity greater than four, neonates born of mothers with parity=1 had on average 79% reduced 0dds for birth asphyxia (OR 0.21, CI 0.07-0.70, P-value=0.01). Neonates born of mothers with parity between 2 and 4 had on average 96% reduced odds (OR 0.04, 95% CI 0.01 – 0.12, P- value < 0.01). Conclusion: High parity and newborn with birth weight >3500g were associated with birth asphyxia. Marital status and education level did not increase the risk of birth asphyxia in the population studied. Keywords: birth asphyxia, maternal factors, parity, labor
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