article · BMC Pregnancy and Childbirth
A cross-sectional study of 582 mother-newborn pairs at Debre Tabor General Hospital evaluated the burden and determinants of birth asphyxia among live births. The investigation recorded a birth asphyxia prevalence of 28.35 per cent. Multiple clinical and obstetric conditions were significantly associated with an increased risk of asphyxia, including fetal malpresentation, premature rupture of fetal membranes, meconium-stained amniotic fluid, and vacuum-assisted delivery. Beyond clinical complications, organisational and staffing factors played a critical role. Deliveries occurring at night and labour attended solely by medical interns exhibited substantially higher risks of neonatal asphyxia. The findings show that birth asphyxia remains a pressing public health concern in this facility, pointing to an urgent need to reinforce emergency obstetric care protocols and improve supervision and staffing arrangements during labour.
Birth asphyxia is a leading cause of neonatal mortality and long-term neurological complications. By detailing how specific intrapartum complications combine with operational factors such as nighttime care and junior staff allocation, this evidence allows health administrators to design targeted interventions. Addressing these clinical and scheduling gaps directly improves maternal and newborn survival rates within hospital maternity wards.
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BACKGROUND: More than one third of the neonatal deaths at Neonatal Intensive Care Unit (NICU) in Debre Tabor General Hospital (DTGH) are attributable to birth asphyxia. Most of these neonates are referred from the maternity ward in the hospital. Concerns have also been raised regarding delayed intrapartum decisions for emergency obstetrics action in the hospital. However, there has been no recent scientific evidence about the exact burden of birth asphyxia and its specific determinants among live births at maternity ward of DTGH. Moreover, the public health importance of delivery time and professional mix of labor attendants haven't been addressed in the prior studies. METHODS: Hospital based cross sectional study was conducted on a sample of 582 mother newborn dyads at maternity ward. Every other mother newborn dyad was included from December 2019 to March 2020. Pre-tested structured questionnaire and checklist were used for data collection. The collected data were processed and entered into Epidata version 4.2 and exported to Stata version 14. Binary logistic regressions were fitted and statistical significance was declared at p less than 0.05 with 95% CI. RESULTS: The prevalence of birth asphyxia was 28.35% [95% CI: 26.51, 35.24%]. From the final model, fetal mal-presentation (AOR = 6.96: 3.16, 15.30), premature rupture of fetal membranes (AOR = 6.30, 95% CI: 2.45, 16.22), meconium stained amniotic fluid (AOR = 7.15: 3.07, 16.66), vacuum delivery (AOR =6.21: 2.62, 14.73), night time delivery (AOR = 6.01: 2.82, 12.79) and labor attendance by medical interns alone (AOR = 3.32:1.13, 9.78) were positively associated with birth asphyxia at 95% CI. CONCLUSIONS: The prevalence of birth asphyxia has remained a problem of public health importance in the study setting. Therefore, the existing efforts of emergency obstetric and newborn care should be strengthened to prevent birth asphyxia from the complications of fetal mal-presentation, premature rupture of fetal membranes, meconium stained amniotic fluid and vacuum delivery. Moreover, night time deliveries and professional mixes of labor and/delivery care providers should be given more due emphasis.
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DOI: 10.1186/s12884-020-03348-2
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