Prevalence and associated factors for birth asphyxia in al-Salam Hospital, Saddah, Yemen

Abstract EN

Objective : To find the prevalence, and identify risk factors and outcome in neonates who were admitted into the Al-Salam Hospital for perinatal asphyxia.

Methods : This was a descriptive cross sectional observational study of neonates with low Apgar scores admitted over a period of ten months into Pediatric Unit of the Al-Salam Saudi Hospital, Saddah, Yemen, from 1 October 2014 to 30 July 2015.

All babies with Apgar scores less than 6 at; one minute and for whom consent was obtained were included in this study.

For outborn babies with no Apgar score recording, a history of poor cry from birth with either poor (pallor) color, respiratory distress, floppiness or loss of primitive reflexes were used.

Relevant maternal history, regarding their age, gestational age, and complications, if any were included.

Results: One hundred and fifty eight out of 632 admitted babies had perinatal asphyxia giving a prevalence of 29.4%.

Mean gestational age of affected babies was 36.84±3.67 weeks, and mean birth weight was 3.0 ± 0.9 kg.

Sixty two (39.5 %) of their mothers had no antenatal care (ANC).

Mode of delivery in 98 (62.4 %) was caesarian section, of which 80 (81.6 %) were emergencies, many of whom had complications before presentation.One hundred and seven (68.2 %) had Apgar score of 4-5 (grade 2, moderate asphyxia) and 38 (24.2%) babies had 0-3 (grade 3, severe asphyxia)in one minute.

The commonest risk factors were cephalopelvic disproportion (CPD) in the mothers and abnormal presentation, predominantly breech in the fetus.

31.6 % of those with severe perinatal asphyxia died.

Conclusions: Prevalence of birth asphyxia is high.

Lack of ANC, CPD and breech presentation were contributory factors.

There is urgent need for both maternal education for ANC and early intervention and skilled care for suspected birth asphyxia babies at birth.