Characteristics and Factors Associated With Severity of Perinatal Asphyxia Among Term Neonates Admitted at Garissa County Referral Hospital New Born Unit - a Descriptive Cross-sectional Study

Abstract

Introduction: Perinatal asphyxia (PA) is one of the leading causes of perinatal and early neonatal morbidity and mortality in developing countries. In Garissa County Referral Hospital, perinatal asphyxia is estimated to account for a significant burden in terms of admissions to the hospital new-born unit. There is need to characterize the babies who suffer from perinatal asphyxia. Objective: The primary objective of this study is to determine the characteristics of neonates with PA admitted in Garissa County Referral Hospital New Born Unit, a public health facility in Kenya. The secondary aim is to determine factors associated with severity of asphyxia. Method: The study design is a cross-sectional. The study population include al term neonates with perinatal asphyxia admitted to the NBU of the Garissa County referral hospital (GCRH) including those delivered at the facility and those referred from other sub county hospitals and their mothers. Neonates were examined within the 24 hours of delivery and data collection was done using a semi-structured questionnaire. The collected data was checked for accuracy, completeness and validity so as to eliminate any inconsistencies and irrelevances. Data analysis Data analysis include both descriptive and inferential analysis. Descriptive analysis was done based on categorical and continuous patient level data. Grouped data were analyzed using frequencies and percentages while continuous data analyzed using mean (standard deviation). Chi-square test and student t-test were used to determine association between risk factors and perinatal asphyxia. Multivariable analysis using logistic regression was done to investigate independent factors associated with perinatal asphyxia. Statistical package for Social Sciences (SPSS version 26) was used for data analysis. Level of statistical significance at 0.05 was used. Results During the study period a total of 195 neonates were admitted in the NBU out of whom 81 had perinatal asphyxia. Of these, 3(4%) had mild asphyxia, 46(57%) with moderate asphyxia and 32(39%) with severe asphyxia. ix Maternal illiteracy [OR 3.3 (95% CI 1.2-8.7), p<0.0159], prolonged first stage of labour [OR 0.4 (95% CI 0.2-0.97), p <0.042], prolonged second stage of labour [OR 0.08 (95% CI 0.009-0.6), p<0.0133], and foetal distress [OR 0.12 (95% CI 0.01-0.8), p<0.0194] were associated with severity of perinatal asphyxia in this study. Conclusions In conclusion, Improved quality of intra-partum care services aimed at monitoring mothers with prolonged labor would prevent fetal complications such as perinatal asphyxia. Recommendations Effort should be made by GCRH administration to improve on the quality of intrapartum care and make a strict monitoring of labor with partograph & enhanced fetal monitoring with cardiotocography machines (CTG) so as to avoid fetal complications that come with prolonged labor