Prevalence and Risk Factors of Birth Asphyxia among Elderly Gravidarum
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Abstract
Objectives: To investigate the prevalence and risk factors of birth asphyxia in pregnancies with advanced maternal age.
Materials and Methods: This study involved a retrospective cohort with a nested case-controlled study. Data were collected at Rajavithi Hospital. The prevalence of birth asphyxia was investigated using a retrospective cohort study of cases from January 2012 to June 2016. Antepartum factors, intrapartum factors and postpartum and newborn factors were studied using a nested case-controlled approach that involved the random matching and analysis of the results according to these factors.
Results: The prevalence of birth asphyxia of advanced maternal age group in this study was 11.7%. The statistically significant risk factors included number of antenatal care (ANC) < 4 visits (adjusted OR 1.64, 95% CI 1.18-2.26), hypertensive disorders (adjusted OR 1.94, 95% CI 1.42 -2.65), placenta previa (adjusted OR 4.58, 95% CI 2.74-7.68), PROM > 18 hours (adjusted OR 3.71, 95% CI 1.98 – 6.98), non-cephalic presentation (adjusted OR 1.95, 95% CI 1.34-2.84), and non-reassuring intrauterine fetal status (adjusted OR 3.35, 95% CI 2.22-5.06). There were no significant risk factor at diabetes disorders (95%CI 0.84-1.42, p = 0.50), meconium stained amniotic fluid (95%CI 0.64-1.73, p = 0.830), administration of analgesic drug (95%CI 0.59-1.91, p = 0.839), and nuchal cord (95%CI 0.59-1.27, p = 0.453).
Conclusions: Birth asphyxia at Rajavithi Hospital was 11.7%. The statistically significant risk factors associated with birth asphyxia were number of ANC < 4 visits, hypertensive disorders, placenta previa, a PROM > 18 hours, non-cephalic presentation, and non- reassuring fetal status or fetal distress.
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References
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