Risk Factors of Perinatal Asphyxia Among Newborns Delivered at Public Hospitals in Addis Ababa, Ethiopia: Case–Control Study

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Abstract
Background: Perinatal asphyxia determines the newborn’s future health status and viability with risk factors yet to be completely understood. It measures the status of the healthcare delivery of an organization including antenatal, intranatal, and postnatal care. In Ethiopia, 31.6% of neonatal mortality was attributed to perinatal asphyxia. This study aimed to assess the risk factors of perinatal asphyxia. Methods: An unmatched case–control study was conducted on 213 (71 cases selected using lottery method and 142 controls systematically) subjects in Addis Ababa from November 1, 2018 to June 30, 2019. Data were collected using a structured questionnaire through face-to-face interviews, entered to Epi data version 4.4, and exported to SPSS version 25 for analysis. Logistic regression was used for analysis. Variables with p< 0.25 in bivariate analysis were taken to multivariable analysis. Statistical significance was declared at P< 0.05 and findings were presented using texts and tables. Results: A total of 210 newborns (70 cases and 140 controls) and their mothers were included with an overall response rate of 98.5%. Antepartum hemorrhage [AOR=7.17; 95% CI 1.73– 29.72], low birth weight [AOR=2.87; 95% CI 1.01– 8.13], preterm birth [AOR=3.4; 95% CI 1.04– 11.16], caesarean section delivery [AOR=2.75; 95% CI 1.01– 7.42], instrumental delivery [AOR=4.88; 95% CI 1.35– 17.61], fetal distress [AOR=4.77; 95% CI 1.52– 14.92] and meconium-stained amniotic fluid [AOR=9.02; 95% CI 2.96– 30.24] were significantly associated with perinatal asphyxia. Hence, efforts ought to go to improve the quality of antenatal and intra-natal services.

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