Determinants of birth asphyxia among new-borns delivered at Yirgalem general hospital, Sidama Regional State, Southern Ethiopia: Unmatched case-control study
Addisalem Tadege Egemo, Ashenafi Mekonnen Woldetsadik, Tigist Yakob, Tsegaye AlemuBackground
Evidence from the World Health Organization, 4 million infants is born each year with asphyxia resulting as the leading cause of death in low- and middle-income countries including Ethiopia. Despite of this fact, there is little known about risk factors in the study area. There is little context-specific evidence in the Sidama Regional State, especially from facility-based analytical studies. In order to guide focused interventions and enhance neonatal outcomes in this context, local evidence generation is crucial.
Objective
aimed to identify determinants of birth asphyxia among new-borns delivered at Yirgalem General Hospital, Sidama regional state, Southern Ethiopia.
Methods
A facility based unmatched case-control study was conducted from April 15- July 25/2023 among 106 cases and 214 controls. All asphyxiated new-borns were enrolled as cases and every two other non-asphyxiated new-borns were taken as controls. Those new-borns with an Apgar score of < 7 at the fifth minute were taken as cases, and those with ≥7 were taken as controls. Data was collected through the Kobo collection toolbox. The data were exported to statistical package for social science(SPSS) version 27 for analysis, the descriptive analysis was conducted for continuous and categorical variables and the finding was presented using text, tables, and figures. Then, Bivariable and multivariable logistic regression analyses were conducted to assess the association between independent variables and birth asphyxia. Hence, variables with a p-value of < 0.25 in the bivariable analysis were included into the multivariable logistic regression model to control for potential confounding. Finally, in the multivariable analysis, variables with a p-value of < 0.05 considered statistically significant.
Results
A total of 320 (106 cases and 214 controls) were included in the study. About, 36.8% of mothers with cases and 14.5% of mothers with controls were not followed by partograph. In multivariable model, mothers who faced complications of labor [AOR=3.6; 95% CI: 1.68, 7.90], vaginal discharge [AOR=5.58; 95% CI: 2.73, 11.42], have not followed by partograph [AOR =4.48; 95% CI:1.99, 5.95], and non-cephalic foetal presentation[AOR=2.32; 95%CI: 1.10, 4.90] were statistically significant associated with birth asphyxia.
Conclusions
This study reported key determinants of asphyxia namely complications of pregnancy, non-cephalic fetal presentation, not use of partograph, vaginal discharge during pregnancy, gestational age (preterm), low birth weight, and mode of delivery. Therefore, findings underscore consistent use of partograph is a key to identify complication early. Midwifes and other health professionals need to work on antenatal care in order to monitor baby presentation and mother health conditions.