The prevalence and outcomes of perinatal asphyxia, pre and post introduction of enhanced newborn care at Kenyatta National Hospital

Abstract

Background: Mortality from perinatal asphyxia can be greatly reduced by effective newborn resuscitation. This study investigated the  effect of a quality improvement intervention on perinatal asphyxia at Kenyatta National Hospital.

Objectives: To determine the prevalence and day 7 outcomes of perinatal pre and post introduction of enhanced newborn care in the  form of a paediatric residents’ maternity unit rotation.

Study Design: Cross sectional survey based on retrospective chart review comparing pre and post paediatric residents’ maternity unit  rotation.

Study population: Term neonates (and their mothers) delivered at the KNH (Kenyatta National Hospital) maternity unit in the  two time periods under consideration.

Data Analysis: Patients’ characteristics and day 7 of life outcomes of babies admitted with  asphyxia from the two periods were compared.

Results: There was a 70% decline in labour ward infant death [OR 0.3 [(95% CI 0.2,0.3)  P=0.000001], and a 50% decline in asphyxia related deaths in the Newborn Unit [OR 0.38 (95% CI 0.3,0,45) P=0.0005] during the residents’  rotation.

Conclusion: Reintroducing paediatric residents’ rotation would improve quality of care.