Risk factors and mortality rate of severely asphyxiated neonates in a tertiary centre in north-central Nigeria

Abstract

Introduction: Asphyxia is a serious clinical condition in which placental or pulmonary gas exchange is impaired or ceases altogether. Reports from Nigeria have shown that a large proportion of neonates are still being diagnosed with and managed for severe birth asphyxia. A large proportion of the risk factors are actually preventable^.

Aim: The study was carried out to determine the maternal and foetal risk factors for the occurrence of severe birth asphyxia and the mortality rate of babies affected with this condition.

Method: Records of all neonates with severe birth asphyxia admitted into the special care baby unit (SCBU) of the Jos university teaching hospital (JUTH) in 2011 were obtained retrospectively and information documented in a questionnaire. 25 other neonates matched for birth weight who were not asphyxiated were selected randomly and constituted the controls. Data was analysed using statistical soft ware EPI-info version 3.5.1. Chi- square test was used for comparison of categorical variables while the T test was used to compare means. A P value of < 0.05 was considered significant.

Results: Fifty (12.6%) of the 398 babies admitted into the SCBU in 2011 were severely asphyxiated. The severely asphyxiated infants were admitted at a significantly earlier age compared to babies without asphyxia P value <0.001. All (100.0%) mothers of the control group and 98.0% of the cases booked for antenatal care. A significantly higher number of mothers whose babies had SBA were multiparous, had prolonged labour or meconium staining of liquor – P values 0.015, 0.004 and 0.035 respectively.. Hypertension including pre- eclampsia, prolonged rupture of membranes, antepartum haemorrhage and precipitate labour were not significant risk factors for severe birth asphyxia in this study. Neonatal jaundice was significantly less common in the cases (52.0%) compared with the controls (76.0%) – P value = 0.046. Necrotizing enterocolitis and neonatal sepsis occurred more commonly in cases and the difference tended towards significance – P value of 0.05 in both cases. The mortality rate of babies with SBA in this study was 28.0% which was significantly higher than in the control group - P value = 0.03.

Conclusion: The mortality rate from severe birth asphyxia is high, improving intrapatrum care services would help reduce the occurrence of SBA in our environment.