Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
June 2015 Vol. 4(6), pp. 270-276
Copyright © 2015 Global Advanced Research Journals

 

Full Length Research Paper

Maternal and fetal determinants of mortality in babies with birth asphyxia at Osogbo, Southwestern Nigeria

Olusegun Joseph Adebami

Neonataology Unit, Department Paediatrics and Child Health, College of Health Sciences, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria

E-mail: ojadebami@lautech.edu.ng,  adebamiolusegun@gmail.com; Telephone: +2348037115347

Accepted 23 June, 2015

Abstract

Birth Asphyxia, defined as a simultaneous occurrence of hypoxic and ischaemic insult severe enough to cause metabolic acidosis, neonatal encephalopathy and multiorgan system dysfunction which now manifest with failure of a newborn to initiate and sustain respiration at birth. Maternal and fetal risk factors have been identified as major predispositions to birth asphyxia. The aim of the present study therefore, was to identify the maternal and fetal perinatal factors contributing to poor outcome (mortality) in babies admitted for birth asphyxia in our hospital in Southwestern Nigeria so as to anticipate the management. Consecutive babies with birth asphyxia were those with APGAR score of ≤ 7 at five minutes2  and/or did not cry immediately after delivery  in the presence of neurologic symptoms, admitted into special care baby’s unit were studied. Of the 1163 babies admitted between 2010 and 2013, 415 (35.7%) were asphyxiated; 227 (54.7%) were males, 188 (45.3%) females, F:M was 1.2:1; However, 99 (23.9%) of the 415 asphyxiated babies died; 11 (11.1%) and 88 (88.9%) had moderate and severe asphyxia respectively. Also, 56 (56.6%) were males and 43 (43.4%) females.  Significantly higher proportion of babies of mothers who had no antenatal care, mothers  from low socioeconomic class 4 and 5, and who delivered outside the health facility (outborn) died (p at least 0.001). More babies who suffered fetal distress, breech delivery and who had meconium stained liquor died (p is at least 0.04). Therefore, multiprong approach to reduce mortality from birth asphyxia is necessary like improvement of social status of women through educational and economic empowerment; provision of affordable, adequate, well equipped and cheap antenatal care to all pregnant mothers;  provision of functional delivery health facilities to attend to mothers in  labour to detect high risk mothers for better anticipatory care.

Keywords: Maternal, Fetal,  Determinants, Birth Asphyxia, Outcome, Nigeria

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