Short term outcome and predictors of survival among birth asphyxiated babies at a tertiary academic hospital in Enugu, South East, Nigeria

Afr Health Sci. 2019 Mar;19(1):1554-1562. doi: 10.4314/ahs.v19i1.29.

Abstract

Background: Birth asphyxia (BA) is a preventable cause of cerebral insults in newborns. It is associated with high morbidity and mortality. Of the 120 million babies born in third world countries annually, it is estimated that about 3.6 million will develop BA.

Objectives: We aimed to determine the short term outcome and predictors of survival among birth asphyxiated babies using Apgar score.

Methods: This study was carried out in the Newborn Unit of Enugu State University Teaching Hospital. In-hospital deliveries (Inborn) and those from other centers (Out-born) with one minute Apgar score ≤ 6 were included. Interviewer administered questionnaire was used to collect data from caregivers. Information sought included gestational age (GA), birth weight (BW), Apgar score, place of delivery and outcome. Data was analyzed using SPSS. Bivariate and multivariate logistic regressions were done.

Results: Of the 150 neonates, 61.3% survived. Majority of the dead were out-born. The difference was statistically significant (p < 0.001). The inborn were about 1.2 times (AOR = 1.22; 95% CI: 1.06-1.78) more likely to survive BA. Among low birth weights (LBWs), 73.9% died, 23.7% of normal weights and 14.3% of macrosomics died. The difference was statistically significant (p < 0.001). The normal weights were about 2 (AOR = 2.23, 95% CI: 1.76-6.25) and the macrosomics about 5 times more likely to survive BA than LBWs. Regarding GA, 78.8%, 17.2% and 18.2% of the pre-terms, term and post-dates died respectively. The difference was statistically significant (p < 0.001). The term babies were about 11 (AOR = 11.27; 95% CI: 4.02-31-56) and post-dates about 9 (AOR = 8.79; 95% CI: 1.43-54.04) times more likely to survive BA than preterms. Other significant factors were degree of asphyxia (p = 0.003), and parental education (p < 0.001).

Conclusion: BW, GA, degree of asphyxia, place of delivery and parental education all predicts survival among birth asphyxiated newborns.

Keywords: Hypoxic Ischemic Encephalopathy (HIE) outcomes; Newborn; birth asphyxia; predictors of survival.

MeSH terms

  • Apgar Score
  • Asphyxia Neonatorum / etiology
  • Asphyxia Neonatorum / mortality*
  • Birth Weight
  • Delivery, Obstetric / methods*
  • Female
  • Gestational Age
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Infant Mortality
  • Infant, Newborn
  • Male
  • Nigeria / epidemiology
  • Pregnancy
  • Prospective Studies
  • Risk Factors
  • Survival Rate
  • Tertiary Care Centers