biostudies-literatureHanding GEuropean Commission590-601https://www.ebi.ac.uk/biostudies/studies/S-EPMC10867390biostudies-literatureUnknown103(3)<h4>Introduction</h4>Birth asphyxia is a leading cause of neonatal mortality in sub-Saharan Africa. The relationship to grand multiparity (GM), a controversial pregnancy risk factor, remains largely unexplored, especially in the context of large multinational studies. We investigated birth asphyxia and its association with GM and referral in Benin, Malawi, Tanzania and Uganda.<h4>Material and methods</h4>This was a prospective cross-sectional study. Data were collected using a perinatal e-Registry in 16 hospitals (four per country). The study population consisted of 80 663 babies (>1000 g, >28 weeks' gestational age) delivered between July 2021 and December 2022. The primary outcome was birth asphyxia, defined by 5-minute appearance, pulse, grimace, activity and respiration score <7. A mulActa obstetricia et gynecologica ScandinavicaBirth asphyxia and its association with grand multiparity and referral among hospital births: A prospective cross-sectional study in Benin, Malawi, Tanzania and Uganda.PMC10867390Horizon 2020 (No 847824)Agossou CHanding GWanduru PStraneo MAbeid MSAnnerstedt KSKandeya BHanson CfalseBirth asphyxia and its association with grand multiparity and referral among hospital births: A prospective cross-sectional study in Benin, Malawi, Tanzania and Uganda.<h4>Introduction</h4>Birth asphyxia is a leading cause of neonatal mortality in sub-Saharan Africa. The relationship to grand multiparity (GM), a controversial pregnancy risk factor, remains largely unexplored, especially in the context of large multinational studies. We investigated birth asphyxia and its association with GM and referral in Benin, Malawi, Tanzania and Uganda.<h4>Material and methods</h4>This was a prospective cross-sectional study. Data were collected using a perinatal e-Registry in 16 hospitals (four per country). The study population consisted of 80 663 babies (>1000 g, >28 weeks' gestational age) delivered between July 2021 and December 2022. The primary outcome was birth asphyxia, defined by 5-minute appearance, pulse, grimace, activity and respiration score <7. A mul2024-01-01T00:00:00Z2024 Mar2025-04-22T21:59:00.294Z2025-04-06T03:56:08.855ZS-EPMC108673903818330810.1111/aogs.14754