Seven-day outcome of term neonates admitted to the newborn unit with perinatal asphyxia at the largest public maternity hospital in Kenya

Abstract

Objective: To study 7-Day outcomes and determine the factors contributing to adverse outcomes in term newborn babies admitted with perinatal asphyxia at a tertiary Maternity hospital newborn unit in Kenya.
Study design, setting and duration: A short descriptive longitudinal study conducted at Pumwani Maternity Hospital newborn unit (the largest public maternity hospital in Kenya). Consecutive sampling was used to attain sample size between October 2020 to February 2021.
Subjects: Term neonates based on gestational age assessment admitted at Pumwani Maternity Hospital Newborn Unit with perinatal asphyxia within the first 24 hours of birth. Neonates with gross congenital anomalies and preterm gestation were excluded.
Outcomes: Hypoxic Ischaemic Encephalopathy (HIE) at birth with evolving status of HIE at 7 days
Results: 15.1% of study participants died, 28.5% continued treatment and 56.4% discharged from hospital. From those discharged, 14.4% had neurological impairment. Prolong duration of resuscitation [OR 2.2 (95% CI 1.7-3.3), p<0. 001], presence of seizures [OR 98.6(95% CI 23.6-411), p<0. 001] and low Apgar score at 5 minutes [OR 0.05(95% CI 0.01-0.23), p<0.001] were associated with adverse outcome. Breech vaginal delivery [OR 21.3 (95% CI 3.1-147.8) p=0.002], prolong
duration of labor [OR 1.3 (95% CI 1.1-1.4), p<0.001] and prolong rupture of membranes [OR 1.3 (95% CI 1.2-1.5), p<0.001] were also associated with adverse outcome.
Conclusion: Perinatal asphyxia has remained a significant contributor to newborn mortality and morbidity at Pumwani Maternity hospital. Improved quality of intra-partum care services to prevent prolonged labor and fetal complications are needed.