Dataset Information

Birth asphyxia related mortality in Northwest Ethiopia: A multi-centre cohort study.

ABSTRACT:

Background

Birth asphyxia is the second leading cause of neonatal death in Ethiopia, next to preterm-associated infections. Understanding the causes of death in asphyxiated newborns will help to design appropriate care. This study identifies predictors of neonatal mortality in asphyxiated newborns in selected hospitals in Northwest Ethiopia.

Methods

An institution-based prospective cohort study of 480 newborns with birth asphyxia was conducted at Debre Markos Comprehensive Specialized Hospital, Shegaw Motta District Hospital, and Injibara General Hospital. All newborns with asphyxia admitted to the neonatal critical care unit from the first of November 2018 to the first of November 2019 were included. Data were obtained prospectively from mothers using an interviewer's administered questionnaire. The Kaplan-Meier survival curve was used to estimate survival time, and Log rank test was used to compare the survival curves. Bivariable and multivariable Cox proportional hazards models were fitted to identify the independent predictors of mortality in asphyxiated newborns. Adjusted hazard Ratios (AHRs) with 95% Cis (Confidence Intervals) were used to measure the strength of association and test statistical significance.

Results

The overall cumulative incidence of mortality among asphyxiated newborns was 42.29% (95% CI: 38%, 46). Asphyxiated neonates with other comorbidities (sepsis, neonatal anemia) (AHR = 2.63, 95% CI:1.69, 4.10), oxygen saturation of 50-69 (AHR = 4.62, 95% CI:2.55, 8.37), oxygen saturation of 70-89 (AHR = 2.82, 95% CI: 1.80, 4.42), severe Apgar score at one minute (AHR = 1.59, 95% CI:1.12, 2.25), neonates with Hypoxic Ischemic Encephalopathy (HIE) (AHR = 6.12, 95% CI:2.23, 16.75) were at higher risk of mortality.

Conclusions

The mortality rate among asphyxiated neonates remains high, and slightly higher than previous studies. Asphyxiated newborns with other comorbidities, severe Apgar score at one minute, who develop HIE, and low oxygen saturation were at higher risk of death. Therefore, designing appropriate interventions and prevention methods should be considered for identified variables.

SUBMITTER: Ketema DB

PROVIDER: S-EPMC9955636 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Birth asphyxia related mortality in Northwest Ethiopia: A multi-centre cohort study.

Ketema Daniel Bekele DB Aragaw Fantu Mamo FM Wagnew Fasil F Mekonnen Misganaw M Mengist Abeba A Alamneh Alehegn Aderaw AA Belay Yihalem Abebe YA Kibret Getiye Dejenu GD Leshargie Cheru Tesema CT Birhanu Molla Yigzaw MY Hibstie Yitbarek Tenaw YT Temesgen Belisty B Alebel Animut A

PloS one 20230224 2

<h4>Background</h4>Birth asphyxia is the second leading cause of neonatal death in Ethiopia, next to preterm-associated infections. Understanding the causes of death in asphyxiated newborns will help to design appropriate care. This study identifies predictors of neonatal mortality in asphyxiated newborns in selected hospitals in Northwest Ethiopia.<h4>Methods</h4>An institution-based prospective cohort study of 480 newborns with birth asphyxia was conducted at Debre Markos Comprehensive Special ...[more]

PMID: 36827349

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Project description:BackgroundBirth asphyxia, which accounts for 31.6% of all neonatal deaths, is one of the leading causes of such mortality in Ethiopia. Early recognition and management of its contributing factors would modify the problem. Thus, this study aimed to identify the determinants of birth asphyxia among live births at the University of Gondar Referral Hospital, northwest Ethiopia.MethodsA hospital-based unmatched case-control study was conducted from April to July 2017.Cases were newborn babies with an APGAR score of < 7at 5 minutes of birth; controls were newborn babies with an APGAR score of ≥7 at 5 minutes of birth. Every other asphyxiated baby was selected as a case and every 6th non-asphyxiated baby as a control. A pretested structured questionnaire was used to collect data on maternal sociodemographic characteristics. A pretested structured checklist was used to retrieve data on ante-partum, intra-partum, and neonatal factors of both cases and controls. Data were entered using Epi Info 7 and analyzed using SPSS 20. The bivariate logistic regression analysis was used to identify the relation of each independent variable to the outcome variable. Variables with p values of up to 0.2 in the bivariate analysis were considered for the multiple logistic regression analysis. An adjusted odds ratio (AOR) with a 95% CI and p-value of <0.05 was used to identify significant variables associated with birth asphyxia.ResultsIn this study, prolonged labor (AOR = 2.75, 95% CI: 1.18, 6.94), cesarean section delivery (AOR = 3.58, 95% CI: 1.13, 11.31), meconium stained amniotic fluid (AOR = 7.69, 95% CI: 2.99, 17.70), fetal distress (AOR = 5.74, 95% CI: 1.53, 21.55), and low birth weight (AOR = 7.72, 95% CI: 1.88, 31.68) were factors which significantly increased the odds of birth asphyxia.ConclusionProlonged labor, cesarean section (CS) delivery, meconium stained amniotic fluid (AF), fetal distress, and low birth weight were the determinants of birth asphyxia. Thus, efforts should be made to improve the quality of intra-partum care services in order to prevent prolonged labor and fetal complications, and to identify and make a strict follow up on mothers with meconium stained amniotic fluid.

Project description:Trauma is the leading cause of mortality in persons under 45 and a significant public health issue. Trauma is the most frequent cause of perioperative mortality among all surgical patients. Little is known about perioperative outcomes among trauma patients in low-income countries. This study aimed to assess the incidence and identify predictors of perioperative mortality among adult trauma victims at Tibebe Ghion Specialised Hospital. From June 1, 2019, to June 30, 2021, a prospective cohort study was conducted at Tibebe Ghion Specialized Hospital. Demographic, pre-hospital and perioperative clinical data were collected using an electronic data collection tool, Research Electronic Data Capture (REDCap). Cox proportional hazard model regression was used to assess the association between predictors and perioperative mortality among trauma victims. Crude and adjusted hazard ratio (HR) with a 95% confidence interval (CI) was computed; a p-value < 0.05 was a cutoff value to declare statistical significance. One thousand sixty-nine trauma patients were enrolled in this study. The overall incidence of perioperative mortality among trauma patients was 5.89%, with an incidence rate of 2.23 (95% CI 1.74 to 2.86) deaths per 1000 person-day observation. Age ≥ 65 years (AHR = 2.51, 95% CI: 1.04, 6.08), patients sustained blunt trauma (AHR = 3.28, 95% CI: 1.30, 8.29) and MVA (AHR = 2.96, 95% CI: 1.18, 7.43), trauma occurred at night time (AHR = 2.29, 95% CI: 1.15, 4.56), ASA physical status ≥ III (AHR = 3.84, 95% CI: 1.88, 7.82), and blood transfusion (AHR = 2.01, 95% CI: 1.08, 3.74) were identified as a significant predictor for perioperative mortality among trauma patients. In this trauma cohort, it was demonstrated that perioperative mortality is a healthcare burden. Risk factors for perioperative mortality among trauma patients were old age, patients sustaining blunt trauma and motor vehicle accidents, injuries at night, higher ASA physical status, and blood transfusion. Trauma care services need improvement in pre-hospital and perioperative care.

Project description:BackgroundBirth asphyxia is a leading cause of infant morbidity and mortality in developing nations, such as Ethiopia. Though Ethiopia has made considerable achievement in the reduction of under-five mortality rate, the neonatal mortality burden has not experienced the same reduction, which may be attributed to birth asphyxia. Thus, this study attempts to assess the prevalence and associated factors of birth asphyxia among newborns in public hospitals in the northeastern Amhara region, Ethiopia.MethodsAn institution-based cross-sectional study was conducted on 357 births from 1st April to 2nd May 2018. The sample size was proportionally allocated to randomly selected three public hospitals namely, Dessie referral hospital, Debre Berhan referral hospital, and Woldia general hospital. The allocation was made by taking the average number of deliveries given in each hospital six months before the data collection period. Using the delivery registration of hospitals a systematic random sampling technique was used to get all study participants. The diagnosis of birth asphyxia was confirmed based on the physician's diagnosis of an APGAR score < 7 in the 1st and 5th minutes of birth. A pretested and structured questionnaire was used to collect data. Variables with p-values < 0.25 in the bivariable analysis were entered into a multivariable logistic regression analysis. A statistical significant level was declared at a p-value of <0.05.ResultsThe prevalence of birth asphyxia was found to occur 22.6% of the time [95% CI 19.2% - 26.4%] in the first minute of birth. In the multivariable logistic regression being primipara [AOR = 3.77: 95% CI 1.86, 7.65], presented with complicated labor [AOR = 3.45: 95% CI 1.58, 7.49], premature rupture of membrane [AOR = 3.85: 95% CI 1.76, 8.44) and having blood-stained amniotic fluid at birth [AOR = 5.02: 95% CI 1.69, 14.87] were the independent predictors of birth asphyxia.ConclusionThe study revealed that birth asphyxia is a common newborn complication in the Amhara region. Integrated mitigation measure to reduce neonatal mortality in the Amahar region should give due attention to primipara women and for these high-risk pregnancies in order for the region to achieve national and global commitment to have sustainable change in women and neonatal health.

Project description:BackgroundMaternal overweight and obesity are associated with increased risks of birth-asphyxia-related outcomes, but the mechanisms are unclear. If a change of exposure (i.e., maternal body mass index [BMI]) over time influences risks, this would be consistent with a causal relationship between maternal BMI and offspring risks. Our objective was to investigate associations between changes in maternal BMI between consecutive pregnancies and risks of birth-asphyxia-related outcomes in the second offspring born at term.Methods and findingsThis study was a prospective population-based cohort study that included 526,435 second-born term (≥37 wk) infants of mothers with two consecutive live singleton term births in Sweden between January 1992 and December 2012. We estimated associations between the difference in maternal BMI between the first and second pregnancy and risks of low Apgar score (0-6) at 5 min, neonatal seizures, and meconium aspiration in the second-born offspring. Odds ratios (ORs) were adjusted for BMI at first pregnancy, maternal height, maternal age at second delivery, smoking, education, mother´s country of birth, inter-pregnancy interval, and year of second delivery. Analyses were also stratified by BMI (<25 versus ≥25 kg/m2) in the first pregnancy. Risks of low Apgar score, neonatal seizures, and meconium aspiration increased with inter-pregnancy weight gain. Compared with offspring of mothers with stable weight (BMI change of -1 to <1 kg/m2), the adjusted OR for a low Apgar score in the offspring of mothers with a BMI change of 4 kg/m2 or more was 1.33 (95% CI 1.12-1.58). The corresponding risks for neonatal seizures and meconium aspiration were 1.42 (95% CI 1.00-2.02) and 1.78 (95% CI 1.19-2.68), respectively. The increased risk of neonatal seizures related to weight gain appeared to be restricted to mothers with BMI < 25 kg/m2 in the first pregnancy. A study limitation was the lack of data on the effects of obstetric interventions and neonatal resuscitation efforts.ConclusionsRisks of birth-asphyxia-related outcomes increased with maternal weight gain between pregnancies. Preventing weight gain before and in between pregnancies may improve neonatal health.

Dataset Information

Birth asphyxia related mortality in Northwest Ethiopia: A multi-centre cohort study.

Background

Methods

Results

Conclusions

Publications

Birth asphyxia related mortality in Northwest Ethiopia: A multi-centre cohort study.

Similar Datasets

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