Risk Factors for Perinatal Asphyxia of Newborns in Nakhonpathom Hospital

Abstract

     A retrospective case-control study design was conducted to identify the risk factors leading to birth asphyxia among newborn infants delivered at Nakhonpathom hospital. The data was collected from maternal record of live birth infants at Nakhonpathom hospital between January 1st 2011 and December 31th 2011. The study group was 199 cases of newborns with Apgar score at 1 minute ≤ 7 and the control group was 398 cases of newborns with Apgar score at 1 minute > 7. Univariate analysis showed that advanced maternal age (OR = 1.810, 95% CI = 1.012-3.237), ANC visits less than 4 times (OR = 2.747, 95% CI = 1.935-3.900), primigravidarum (OR = 1.595, 95% CI = 1.117-2.277), hypertension (OR = 1.795, 95% CI = 1.043-3.091), maternal anemia (OR = 1.712, 95% CI = 1.086-2.697), breech delivery (p < 0.05), vaccum or forceps extraction (OR = 6.305, 95% CI = 1.793-22.173), cesarean section (OR = 2.660, 95% CI = 1.847-3.830), chorioamnionitis (OR = 4.800, 95% CI = 1.228-18.768), thick meconium (OR = 16.163, 95% CI = 6.189-42.211), oligohydramnios (OR = 3.457, 95% CI = 1.238-9.653), refer in (OR = 3.546, 95% CI = 2.377-5.288), IUGR (p < 0.05), twin pregnancy (OR = 6.103, 95% CI = 2.367-15.735), birthweight < 2,500 gm (OR = 7.241, 95% CI = 4.711-11.131), preterm delivery (OR = 5.505, 95% CI = 3.670-8.258), and fetal distress (OR = 8.341, 95% CI = 4.539-15.326) were significant risk factors for birth asphyxia. After multiple logistic regression analysis was done, the factors which were statistically significant were thick meconium (OR = 18.452, 95% CI = 6.392-53.262), vaccum or forceps extraction (OR = 7.746, 95% CI = 1.897-31.641), chorioamnionitis (OR = 5.620, 95% C I = 1.195-26.426), fetal distress (OR = 4.501, 95% CI = 2.091-9.689), birthweight < 2,500 gm (OR = 4.452, 95% CI = 2.157-9.186), cesarean section (OR = 2.076, 95% CI = 1.258-3.425) and refer in (OR = 1.966, 95% CI = 1.164-3.322).