A retrospective analysis of clinical spectrum and risk factors of perinatal asphyxia in neonates admitted in Special Newborn Care Unit of Central India.

Background: WHO has defined birth asphyxia as failure to initiate and sustain breathing at birth. perinatal Asphyxia is an insult to the newborn due to lack of oxygenation and perfusion. Early identification and control of the determinants and risk factors of perinatal asphyxia can reduce the newborn hospitalizations and mortality. The goal of the study was to analyze the clinical spectrum of perinatal asphyxia and to evaluate the risk factors associated with birth asphyxia. Methods: The study was conducted at Special Newborn Care Unit (SNCU), Bundelkhand Medical College, Sagar, during the study period from May 22 to May 23. All neonates who fulfilled the inclusion criteria and were diagnosed as perinatal asphyxia (history of delayed cry or Apgar score of less than 7 in 5 minutes) (n=190) were included in the study. The data was collected retrospectively from SNCU records, including the maternal and neonatal risk factors. Results: During the study period, there were 8290 live births, of whom 1711 neonates were admitted to SNCU. Among them 190 neonates were diagnosed with birth asphyxia. The cases of perinatal asphyxia accounted for 11.10 % of the SNCU admissions and 22.91/1000 live births. Among them, 78(41.1%) were females and 112(58.9%) were males. 122(64.21%) had birth weight more than 2.5kg, 131(68.9%) were born full term and 158(83.2%) were born intramurally. 34 (17.89%) mothers were having hypothyroidism. 131(68.95%) neonates were born by spontaneous normal vaginal delivery, whereas 59(31.05%) neonates were delivered by caesarean section. Most 99(52.11%) neonates were delivered after uneventful course, 60(31.58%) had prolonged second stage of labor and whereas 31(16.32%) neonates were delivered after obstructed labor. The common co-morbidities present were respiratory distress in 34(17.9%) neonates, low birth weight<1800gm in 10(5.3%) neonates and sepsis in 8(4.2%) neonates. Although less common, 3(1.6%) neonates each also additionally presented with apnea, meconium aspiration and neonatal hyperbilirubinemia. Conclusion: Perinatal Asphyxia is one of the commonest causes of admission in SNCU. Most newborns were intramural, full term,>2.5kg with male preponderance. Maternal conditions associated with perinatal asphyxia were prolonged second stage of labor, obstructed labour and institutional delivery at the study centre, as also maternal hypothyroidism. Birth asphyxia is commonly associated with co-morbidities like respiratory distress, low birth weight<1800gm and sepsis. [ABSTRACT FROM AUTHOR]