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      Prevalence and contributing factors of birth asphyxia among the neonates delivered at Nigist Eleni Mohammed memorial teaching hospital, Southern Ethiopia: a cross-sectional study

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          Abstract

          Background

          Birth asphyxia is a major contributor to neonatal mortality worldwide. In Ethiopia, birth asphyxia remains a severe condition that leads to significant mortality and morbidity. This study aims to assess the prevalence and contributing factors of birth asphyxia among the neonates delivered at the Nigist Eleni Mohammed Memorial Teaching Hospital, Southern Ethiopia.

          Methods

          This hospital-based cross-sectional study was carried out on 279 participants using the systematic sampling method during June 1–30, 2019. Data were collected using a pretested structured interviewer administered questionnaire, check list and chart review, which was used to retrieve medical information and mother’s test results that could not be captured by the interview . Data were entered into EpiData (version 3.1) and analyzed using SPSS software (version 24). Multivariable regression analysis was used to identify the association between the independent variables and outcome variable with a 95% confidence interval (CI).

          Result

          The overall prevalence of birth asphyxia among newborns was found to be 15.1%. Factors that were significantly associated with birth asphyxia included mothers aged ≥35 (AOR = 6.4; 95% CI = 2.0–20.5), primigravida (AOR = 5.1; 95% CI =2.0–13.3), prolonged second stage of labor (AOR = 4.6; 95%CI =1.6–13.3), preterm birth (AOR = 4.7; 95% CI =1.5–14.1), meconium stained amniotic fluid (AOR = 7.5; 95% CI =2.5–21.4) and tight nuchal (AOR = 3.1; 95% CI =1.2–9.3).

          Conclusion

          Birth asphyxia is still prevalent in the study setting. The obtained findings indicated that the mothers aged ≥35, being primigravida, preterm birth, meconium stained amniotic fluid and tight nuchal were the factors associated with birth asphyxia. The results of this study show the need for better maternal care, creating awareness about contributing factors of birth asphyxia to the maternity health professionals, careful monitoring of labor, and identifying and taking proper measures that could help in reducing the occurrence of birth asphyxia.

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          Most cited references30

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          Surfactant replacement therapy for preterm and term neonates with respiratory distress.

          Respiratory failure secondary to surfactant deficiency is a major cause of morbidity and mortality in preterm infants. Surfactant therapy substantially reduces mortality and respiratory morbidity for this population. Secondary surfactant deficiency also contributes to acute respiratory morbidity in late-preterm and term neonates with meconium aspiration syndrome, pneumonia/sepsis, and perhaps pulmonary hemorrhage; surfactant replacement may be beneficial for these infants. This statement summarizes the evidence regarding indications, administration, formulations, and outcomes for surfactant-replacement therapy. The clinical strategy of intubation, surfactant administration, and extubation to continuous positive airway pressure and the effect of continuous positive airway pressure on outcomes and surfactant use in preterm infants are also reviewed.
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            Cause of neonatal deaths in Northern Ethiopia: a prospective cohort study

            Background Despite the significant reduction in childhood mortality, neonatal mortality has shown little or no concomitant decline worldwide. The dilemma arises in that the lack of documentation of cause of death in developing countries, where registration of vital events is virtually nonexistent. Understanding of the causes of death in neonates is important to guide public health interventions. The present study identifies the common causes of neonatal death in Ethiopia. Methods A prospective cohort study was conducted among neonates born between April 2014 and July 2014 in seven hospitals, in Tigray region, Ethiopia. Mothers were interviewed by midwifes respecting risk factors and infant survival. For neonates who died in hospital, causes of death were extracted from medical records, whereas a verbal autopsy method provided presumptive assignment of cause of death for those infants who died at home. Results Of the1152 live births, there were 68 deaths (63 per 1000 live births). Two thirds of deaths were attributable to prematurity 23 (34%) or asphyxia 21 (31%). Slight variance was seen between the morality patterns in early and late neonatal periods. In the early neonatal period, 37% were due to prematurity, while asphyxia (35%) was more common in the late neonatal period. All infection-related deaths occurred in neonate-mother dyads from rural areas. Conclusion Prematurity, asphyxia, and infections were the leading causes of neonatal deaths in Tigray region during the study period. Causes of deaths identified during early and late neonatal mortality differed, which clearly indicates the need for responsive and evidence-based interventions and policies.
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              Risk factors for neonatal mortality due to birth asphyxia in southern Nepal: a prospective, community-based cohort study.

              Our goal was to identify antepartum, intrapartum, and infant risk factors for birth asphyxia mortality in a rural, low-resource, population-based cohort in southern Nepal. Data were collected prospectively during a cluster-randomized, community-based trial evaluating the impact of newborn skin and umbilical cord cleansing on neonatal mortality and morbidity in Sarlahi, Nepal. A total of 23662 newborn infants were enrolled between September 2002 and January 2006. Multivariable regression modeling was performed to determine adjusted relative risk estimates of birth asphyxia mortality for antepartum, intrapartum, and infant risk factors. Birth asphyxia deaths (9.7/1000.0 live births) accounted for 30% of neonatal mortality. Antepartum risk factors for birth asphyxia mortality included low paternal education, Madeshi ethnicity, and primiparity. Facility delivery; maternal fever; maternal swelling of the face, hands, or feet; and multiple births were significant intrapartum risk factors for birth asphyxia mortality. Premature infants (<37 weeks) were at higher risk, and the combination of maternal fever and prematurity resulted in a 7-fold elevation in risk for birth asphyxia mortality compared to term infants of afebrile mothers. Maternal infections, prematurity, and multiple births are important risk factors for birth asphyxia mortality in the low-resource, community-based setting. Low socioeconomic status is highly associated with birth asphyxia, and the mechanisms leading to mortality need to be elucidated. The interaction between maternal infections and prematurity may be an important target for future community-based interventions to reduce the global impact of birth asphyxia on neonatal mortality.
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                Author and article information

                Contributors
                ritbano2244@gmail.com
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                30 December 2019
                30 December 2019
                2019
                : 19
                : 536
                Affiliations
                Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
                Author information
                http://orcid.org/0000-0003-2867-7526
                Article
                2696
                10.1186/s12884-019-2696-6
                6937931
                31888542
                c27b331a-2a79-483b-b302-033f0d5a3732
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 September 2019
                : 23 December 2019
                Funding
                Funded by: Wachemo University
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Obstetrics & Gynecology
                birth asphyxia,prevalence,contributing factors
                Obstetrics & Gynecology
                birth asphyxia, prevalence, contributing factors

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