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ANTENATAL AND INTRAPARTUM RISK FACTORS FOR BIRTH ASPHYXIA AMONG EMERGENCY OBSTETRIC REFERRALS IN MULAGO HOSPITAL, KAMPALA, UGANDA
Abstract
ABSTRACT
Introduction: Many perinatal deaths follow birth asphyxia that occurs in babies of women
who are referred on developing life-threatening obstetric complications.
Objective: To determine the antenatal and intrapartum risk factors for severe birth
asphyxia among babies delivered by women admitted as emergency obstetric referrals.
Setting: Mulago hospital, the National Referral Hospital, Kampala, Uganda.
Design: Case-control study
Subjects: Cases wore newborn term babies (and their mothers) with a 5-minute Apgar
score 4 or less (birth asphyxia). Controls were term newborn babies with a 5-minute
Apgar score more than 4.
Main outcome measures: Antepartum and intraparturn risk factors among newborn
babies (and their mothers). from socio-demographic characteristics, obstetric complications
or labour management. The Odds ratios (OR) for various outcomes were calculated
using the Statistical Assistance Software (SAS) version 6.2 (Windows), and are presented
with their 95% confidence intervals (C1) and p- values.
Results. There was no association between socio-demographic factors and birth asphyxia.
Antepartum hospitalization, aliteparturn or intrapartum anaemia, anteparturn
hemorrhage and severe pre-eclampsia/eclampsia were significantly associated with birth
asphyxia; the respective ORs and 95% Cl were 1.73 (1,09-2.75), 5.65 (3.36-9.50). 2.12
(1.11-4.05) and 10.62 (2.92-38.47), Augmentation of labour with oxytocin, premature
rupture of membranes, meconium staining of liquor amnii, vacuum extraction, caesarean
section, low birth weight and mal-presentations were significantly associated with birth
asphyxia with ORs of 5.76 (2.20-15.05), 2.23 (01,31 -3.37), 6.40 (2.76-14.82), 2.16 (l.28-
3.67), 2.36 (1.07-5,20) and 6.32 (3.57-11.20) respectively.
Conclusions: Early recognition of these complications among emergency obstetric
referrals, followed by prompt and appropriate management, may reduce the perinatal
deaths from birth asphyxia.
Introduction: Many perinatal deaths follow birth asphyxia that occurs in babies of women
who are referred on developing life-threatening obstetric complications.
Objective: To determine the antenatal and intrapartum risk factors for severe birth
asphyxia among babies delivered by women admitted as emergency obstetric referrals.
Setting: Mulago hospital, the National Referral Hospital, Kampala, Uganda.
Design: Case-control study
Subjects: Cases wore newborn term babies (and their mothers) with a 5-minute Apgar
score 4 or less (birth asphyxia). Controls were term newborn babies with a 5-minute
Apgar score more than 4.
Main outcome measures: Antepartum and intraparturn risk factors among newborn
babies (and their mothers). from socio-demographic characteristics, obstetric complications
or labour management. The Odds ratios (OR) for various outcomes were calculated
using the Statistical Assistance Software (SAS) version 6.2 (Windows), and are presented
with their 95% confidence intervals (C1) and p- values.
Results. There was no association between socio-demographic factors and birth asphyxia.
Antepartum hospitalization, aliteparturn or intrapartum anaemia, anteparturn
hemorrhage and severe pre-eclampsia/eclampsia were significantly associated with birth
asphyxia; the respective ORs and 95% Cl were 1.73 (1,09-2.75), 5.65 (3.36-9.50). 2.12
(1.11-4.05) and 10.62 (2.92-38.47), Augmentation of labour with oxytocin, premature
rupture of membranes, meconium staining of liquor amnii, vacuum extraction, caesarean
section, low birth weight and mal-presentations were significantly associated with birth
asphyxia with ORs of 5.76 (2.20-15.05), 2.23 (01,31 -3.37), 6.40 (2.76-14.82), 2.16 (l.28-
3.67), 2.36 (1.07-5,20) and 6.32 (3.57-11.20) respectively.
Conclusions: Early recognition of these complications among emergency obstetric
referrals, followed by prompt and appropriate management, may reduce the perinatal
deaths from birth asphyxia.
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