Maternal, obstetric, and foetal risk factors for perinatal asphyxia: Prevalence and outcome at a tertiary hospital in Port Harcourt, Nigeria

Abstract

Background: Perinatal asphyxia is a common global neonatal problem which significantly contributes to both morbidity and mortality of newborns, particularly in developing countries, with different risk factors predominating in different settings. Aims: The aims of this study were to investigate the prevalence, risk factors, and outcome of Apgar score-defined perinatal asphyxia at the Rivers State University Teaching Hospital (RSUTH). Materials and Methods: This was a retrospective case–control study in term newborns, with perinatal asphyxia defined as Apgar score <7 at five minutes, over a three-year period between January 2018 and December 2020. A matched control group with Apgar score ≥7 was used for comparison. Data were retrieved from hospital records of all the participants using a structured pro forma. Analysis was done using SPSS version 20 and statistical significance set at P < 0.05. Results: There were 5979 live births, of which 75 babies had perinatal asphyxia, giving a prevalence of 12.5 per 1000 live births. Foetal distress was significantly associated with perinatal asphyxia, with odds ratio (OR) = 19.9 (95% confidence interval [CI]: 6.53–60.64). The significant finding on bivariate analysis of mode of delivery (P = 0.003) and prolonged labour (P = 0.001) as risk factors lost significance on multivariate analysis. The case fatality in asphyxiated newborns was 32.1% and Sarnat Stage III was a significant risk factor for mortality, with OR = 195.0 (95% CI: 11.06–3437). Conclusion: The study has shown that perinatal asphyxia is a common problem at the RSUTH, with a high mortality rate. The most significant risk factor was foetal distress in labour. This can be reduced with good obstetric intervention in terms of adequate foetal monitoring in pregnancy and during labour.