FACTORS CONTRIBUTING TO BIRTH ASPHYXIA AS THE MAJOR COMPLICATION AMONG NEWBORNS DELIVERED AT GITWE DISTRICT HOSPITAL, SOUTHERN PROVINCE, RWANDA.

Abstract

ABSTRACT

Background: Birth asphyxia is the failure to initiate and sustain breathing at birth leads to decrease oxygen perfusion to various organs. According to WHO, 4 million neonatal deaths occurred each year due to birth asphyxia. This study was aimed at evaluating antepartum, intrapartum, and fetal risk factors of birth asphyxia as the main complication among neonates delivered at Gitwe District Hospital

Materials and Methods: This was a case-control study, conducted from September 2016 to January 2017 at Gitwe District Hospital. Neonates diagnosed with birth asphyxia were considered as "cases" while neonates born either with normal vaginal delivery or by a cesarian section having no abnormality were considered as "control".  All data were entered and analysed through STATA 12 and the significant association was at 5% level.

Results: Out of total 248 neonates, 54 were “cases” and 194 were “control”. Significant antepartum risk factors were maternal age of 35+ (aOR= 2.2, 95% CI: 1.20-2.80), incomplete ANC (aOR= 1.30, 95% CI: 1.10-2.17), HIV (aOR= 5.8, 95%CI: 1.84-52.0). Significant Intrapartum risk factors were breech presentation (aOR= 2.8, 95% CI: 1.40-18.51), home delivery (aOR= 3.31, 95%CI: 2.2-6.7), long labor duration (aOR=2.0 95% CI: 2.41 – 12.3), and eclampsia(aOR=2.2, 95%CI:3.1 – 15.6) . Significant fetal risk factors were lower birth weight (aOR = 4.2, 95% CI: 2.2 – 8.5).

Conclusion: Considering the findings of the study, there is an urgent need to develop strategies for their early identification and management by involving women, health professionals and policy makers. In addition to what they do, community health workers should be trained for emergency obstetric care, basic newborn care including preliminary resuscitation measures to provide skilled birth attendance and encourage early recognition and referral to avoid a home delivery.

Keywords: Birth asphyxia, case-control study, Gitwe District Hospital, Rwanda