Maternal factors associated with birth asphyxia at the University Teaching Hospitals, Lusaka, Zambia
Abstract
Background: 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, laborAll authors who submit their paper for publication will abide by following provisions of the copyright transfer: 1. The copyright of the paper rests with the authors. And they are transferring the copyright to publish the article and used the article for indexing and storing for public use with due reference to published matter in the name of concerned authors. 2. The authors reserve all proprietary rights such as patent rights and the right to use all or part of the article in future works of their own such as lectures, press releases, and reviews of textbooks. 3. In the case of republication of the whole, part, or parts thereof, in periodicals or reprint publications by a third party, written permission must be obtained from the Managing Editor of JPRM. 4. The authors declare that the material being presented by them in this paper is their original work, and does not contain or include material taken from other copyrighted sources. Wherever such material has been included, it has been clearly indented or/and identified by quotation marks and due and proper acknowledgements given by citing the source at appropriate places. 5. The paper, the final version of which they submit, is not substantially the same as any that they had already published elsewhere. 6. They declare that they have not sent the paper or any paper substantially the same as the submitted one, for publication anywhere else. 7. Furthermore, the author may only post his/her version provided acknowledgement is given to the original source of publication in this journal and a link is inserted wherever published. 8. All contents, Parts, written matters, publications are under copyright act taken by JPRM. 9. Published articles will be available for use by scholars and researchers. 10. IJPRM is not responsible in any type of claim on publication in our Journal. .