Determinants of birth asphyxia in urban south Ethiopia

Abstract Birth asphyxia is a well-known cause of neonatal mortality, and the survivors suffer from long-lasting sequels such as seizures, intellectual disabilities, and motor disorders that are great challenges for newborns. Elucidating the determinants of birth asphyxia helps implement evidence-based practice in the local context. Thus, this study aimed at elucidating the determinants of birth asphyxia in urban south Ethiopia. A community-based unmatched nested case-control study was conducted on a cohort of 2548 pregnant women who were followed up until delivery in urban areas of Hadiya Zone, south Ethiopia. All newborns who experienced birth asphyxia (n = 118) were taken as cases. Newborns who were randomly selected from the risk-set (n = 472) were taken as controls (those without birth asphyxia). A binary logistic regression was done using R software. Induction of labor [AOR = 2.98, 95% CI: 1.20, 7.42], prolonged labor [AOR = 2.12, 95% CI: 1.02, 4.37], delivery through cesarean section [AOR = 3.81, 95% CI: 1.67, 8.72], instrumental delivery [AOR = 3.91, 95% CI: 1.72, 8.89], and low birth weight [AOR = 6.52, 95% CI: 3.40, 12.51] were determinants of birth asphyxia. Asphyxia during birth was mainly related to obstetric care and maternal nutrition, highlighting the need to pay attention during the course of labor and maternal nutrition during pregnancy. This study might have selection bias and loss of power so careful interpretation of the results is needed.