Prevalence and Factors Associated Birth Asphyxia in Ratchaphiphat Hospital

Abstract

Prevalence and Factors Associated Birth Asphyxia in Ratchaphiphat Hospital

Attapol     Kerd-arunsuksri            MD

General Practice Section, Ratchaphiphat Hospital

Objective: To determine prevalence and the factors associated with birth asphyxia of newborn in Ratchaphiphat hospital.

Study design: Case-control study.

Setting: Labor room, Ratchaphiphat hospital.

Subjects: All of 3,063 pregnant  women who underwent child delivery in Ratchaphiphat hospital during January 1, 2001-December 31, 2003

Methods: Prevalence  was studied by cross-sectional study. Factors associated with birth asphyxia were studied by unmatched case-control study design. The study group consisted of 139 pregnant women delivered newborn with 1 or 5 minute-Apgar score less than 7. The control group consisted of 139 pregnant women delivered equal to or more than 7, deliver at the nearest time after the study group in ratio case : control = 1 : 1. Eighteen. Factors were studied by univariable and multivariable analysis to find out the independent associated factors.

Main outcome measures: Prevalence and factors associated with birth asphyxia

Results: The prevalence of birth asphyxia was 45.4 case per 1,000 livebirths. Using multiple logistic regression, factors which were significantly associated with birth asphyxia were moderate to thick meconium stained of amniotic fluid (OR = 8.96, 95 % CI 2.23 - 25.46), prolonged second stage (OR = 5.79, 95 % CI 2.65 - 9.83), oxytocin used (OR = 6.14,95 % CI 1.55 - 8.67) pethidine used (OR = 7.02, 95 % CI 1.48 - 13.83) and mode of delivery (OR = 5.41, 95 % CI 1.68 - 9.14) Birth asphyxia was found in 47.37, 32.00,14.58, 3.76 and 3.26 percent in newborn delivered by breech delivery, vacuum delivery, forceps delivery, normal delivery and cesarean section, respectively.

Conclusion: The prevalence of birth asphyxia was 45.4 case per 1,000 livebirths. Factors associated with birth asphyxia were moderate to thick meconium stained of amniotic fluid,prolonged second stage, oxytocin used,pethidine used and mode of delivery. Most of the factors associated with birth asphyxia were simple to identify. Early detection and appropriate care should decrease birth asphyxia.

Key words: associated factors, birth asphyxia, low Apgar score

Vajira Med J 2004 ; 48 : 79 - 86