Birth Asphyxia in a Nigerian Mission Hospital in Benin City
Background: Although birth asphyxia is a leading cause of neonatal morbidity and mortality in Nigeria, it has received limited attention in terms of policy and funding priority partly because of lack robust perinatal statistics. Survivors have increased risk of long-term neurologic disability.
Objective: To determine the prevalence of birth asphyxia and document the predisposing factors and outcome.
Methods: In this cross-sectional study at St Philomena Catholic Hospital, the one-and-five-minute Apgar scores of 2,208 live-births were recorded. Those with low Apgar scores ( 6 at one minute) were studied and their data analyzed.
Results: Birth asphyxia occurred in 83.8 per 1000 live-births. The associated significant factors were preterm and post-term deliveries, primiparity, grand multiparity, maternal age 19 years or 40 years and
pregnancy-induced hypertension. Severe birth asphyxia was commonest in breech deliveries. Postasphyxial seizures occurred in 11.9% of asphyxiated infants with 86.4% of them occurring within the first 12 hours after birth. Birth asphyxia accounted for 25.9% of total neonatal deaths with 58.7% of
these deaths occurring within the first 24 hours after birth. Overall case fatality rate was 15.7%. Poor suck, persistent hypotonia, drooling of saliva and seizures were the poor prognostic indicators associated with death. The frequency of severe birth asphyxia as well as deaths were higher in males than females.
Conclusion: Disease-specific burden of birth asphyxia remains enormous and will be alleviated if careful attention is paid to management of labour of high-risk expectant mothers, coupled with availability of personnel skilled in neonatal resuscitation at these deliveries.
Keywords: Birth Asphyxia, Prevalence, Outcome, Nigeria.