Clinical profile and short-term outcome of asphyxiated infants: A prospective study in south-western, Nigeria

Abstract

Background: Perinatal asphyxia is a leading cause of neonatal morbidity and mortality worldwide but with a relatively higher burden in the developing countries.
Aims: To determine the prevalence and outcome of perinatal asphyxia among the participants. Also, possible factors associated with neurodevelopmental delay in infancy were evaluated.
Method: This was a prospective observational study of all asphyxiated neonates admitted into the Neonatal Intensive Care Unit (NICU) of Mother and Child Hospital, Akure from January 2014 to December 2015. They were followed up till the age of 6 months. Data on sociodemographic characteristics, clinical features and outcomes of the participants were documented and analysed. Odd ratio (OR) and 95% confidence interval (CI) were computed for predictors of neurodevelopmental delay. Pvalue < 0.05 was  considered significant.
Results: Of the 1,749 babies admitted into the NICU, 125 had features of perinatal asphyxia giving a prevalence of 7.2%. Seventy-four of the babies were males and 51 were females giving a male: female ratio of 1.5:1. Spontaneous vertex delivery (47.2%) and emergency lower segment Caesarean section (30.4%) were the commonest routes of delivery. Prolonged labour was a major risk factor for asphyxia. Factors significantly associated with poor neonatal outcome include male gender (OR= 3.24, 95% CI = 1.02-10.35) and 5-minute APGAR < 5 (OR=4.36, 95% CI = 1.61-11.79). Also, low Apgar score (p=0.004, OR= 3.37, 95% CI = 1.45-7.82) and low
birth weights (p = 0.05, OR = 2.46,\ 95% CI = 0.99-6.12) were associated with delayed developmental milestones in infancy.
Conclusion: The prevalence of aspyhxia in the current study was 7.2%; the major risk factor was prolonged labour and mortality rate was 9.7% while 10% had delayed developmental milestone at 6 months of life.

Keywords: Clinical profile, outcome, PerinatalAsphyxia, Mother and Child Hospital.