Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study
Abstract Background Birth asphyxia is one of the leading causes of neonatal mortality worldwide. In Uganda, it accounts for 28.9% of all neonatal deaths. With a view to inform policy and practice interventions to reduce adverse neonatal outcomes, we aimed to determine the prevalence and factors asso...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-10-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-05095-y |
| _version_ | 1817983908040409088 |
|---|---|
| author | Elizabeth Ayebare Claudia Hanson Jolly Nankunda Anna Hjelmstedt Rebecca Nantanda Wibke Jonas James K. Tumwine Grace Ndeezi |
| author_facet | Elizabeth Ayebare Claudia Hanson Jolly Nankunda Anna Hjelmstedt Rebecca Nantanda Wibke Jonas James K. Tumwine Grace Ndeezi |
| author_sort | Elizabeth Ayebare |
| collection | DOAJ |
| description | Abstract Background Birth asphyxia is one of the leading causes of neonatal mortality worldwide. In Uganda, it accounts for 28.9% of all neonatal deaths. With a view to inform policy and practice interventions to reduce adverse neonatal outcomes, we aimed to determine the prevalence and factors associated with birth asphyxia at two referral hospitals in Northern Uganda. Methods This was a cross-sectional study, involving women who gave birth at two referral hospitals. Women in labour were consecutively enrolled by the research assistants, who also attended the births and determined Apgar scores. Data on socio-demographic characteristics, pregnancy history and care during labour, were obtained using a structured questionnaire. Participants were tested for; i) malaria (peripheral and placental blood samples), ii) syphilis, iii) white blood cell counts (WBC), and iv) haemoglobin levels. The prevalence of birth asphyxia was determined as the number of newborns with Apgar scores < 7 at 5 min out of the total population of study participants. Factors independently associated with birth asphyxia were determined using multivariable logistic regression analysis and a p-value < 0.05 was considered statistically significant. Results A total of 2,930 mother-newborn pairs were included, and the prevalence of birth asphyxia was 154 [5.3% (95% confidence interval: 4.5- 6.1)]. Factors associated with birth asphyxia were; maternal age ≤ 19 years [adjusted odds ratio (aOR) 1.92 (1.27–2.91)], syphilis infection [aOR 2.45(1.08–5.57)], and a high white blood cell count [aOR 2.26 (1.26–4.06)], while employment [aOR 0.43 (0.22–0.83)] was protective. Additionally, referral [aOR1.75 (1.10–2.79)], induction/augmentation of labour [aOR 2.70 (1.62–4.50)], prolonged labour [aOR 1.88 (1.25–2.83)], obstructed labour [aOR 3.40 (1.70–6.83)], malpresentation/ malposition [aOR 3.00 (1.44–6.27)] and assisted vaginal delivery [aOR 5.54 (2.30–13.30)] were associated with birth asphyxia. Male newborns [aOR 1.92 (1.28–2.88)] and those with a low birth weight [aOR 2.20 (1.07–4.50)], were also more likely to develop birth asphyxia. Conclusion The prevalence of birth asphyxia was 5.3%. In addition to the known intrapartum complications, teenage motherhood, syphilis and a raised white blood cell count were associated with birth asphyxia. This indicates that for sustained reduction of birth asphyxia, appropriate management of maternal infections and improved intrapartum quality of care are essential. |
| first_indexed | 2024-04-13T23:39:01Z |
| format | Article |
| id | doaj.art-721a4cc4b6c44a648c170e3a642fc443 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-13T23:39:01Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-721a4cc4b6c44a648c170e3a642fc4432022-12-22T02:24:36ZengBMCBMC Pregnancy and Childbirth1471-23932022-10-0122111210.1186/s12884-022-05095-yFactors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional studyElizabeth Ayebare0Claudia Hanson1Jolly Nankunda2Anna Hjelmstedt3Rebecca Nantanda4Wibke Jonas5James K. Tumwine6Grace Ndeezi7Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere UniversityDepartment of Public Health Sciences, Karolinska InstitutetMulago Specialized Women’s & Neonatal HospitalDepartment of Women’s and Children’s Health, Karolinska InstitutetMakerere University Lung Institute, College of Health Sciences, Makerere UniversityDepartment of Women’s and Children’s Health, Karolinska InstitutetDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere UniversityDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere UniversityAbstract Background Birth asphyxia is one of the leading causes of neonatal mortality worldwide. In Uganda, it accounts for 28.9% of all neonatal deaths. With a view to inform policy and practice interventions to reduce adverse neonatal outcomes, we aimed to determine the prevalence and factors associated with birth asphyxia at two referral hospitals in Northern Uganda. Methods This was a cross-sectional study, involving women who gave birth at two referral hospitals. Women in labour were consecutively enrolled by the research assistants, who also attended the births and determined Apgar scores. Data on socio-demographic characteristics, pregnancy history and care during labour, were obtained using a structured questionnaire. Participants were tested for; i) malaria (peripheral and placental blood samples), ii) syphilis, iii) white blood cell counts (WBC), and iv) haemoglobin levels. The prevalence of birth asphyxia was determined as the number of newborns with Apgar scores < 7 at 5 min out of the total population of study participants. Factors independently associated with birth asphyxia were determined using multivariable logistic regression analysis and a p-value < 0.05 was considered statistically significant. Results A total of 2,930 mother-newborn pairs were included, and the prevalence of birth asphyxia was 154 [5.3% (95% confidence interval: 4.5- 6.1)]. Factors associated with birth asphyxia were; maternal age ≤ 19 years [adjusted odds ratio (aOR) 1.92 (1.27–2.91)], syphilis infection [aOR 2.45(1.08–5.57)], and a high white blood cell count [aOR 2.26 (1.26–4.06)], while employment [aOR 0.43 (0.22–0.83)] was protective. Additionally, referral [aOR1.75 (1.10–2.79)], induction/augmentation of labour [aOR 2.70 (1.62–4.50)], prolonged labour [aOR 1.88 (1.25–2.83)], obstructed labour [aOR 3.40 (1.70–6.83)], malpresentation/ malposition [aOR 3.00 (1.44–6.27)] and assisted vaginal delivery [aOR 5.54 (2.30–13.30)] were associated with birth asphyxia. Male newborns [aOR 1.92 (1.28–2.88)] and those with a low birth weight [aOR 2.20 (1.07–4.50)], were also more likely to develop birth asphyxia. Conclusion The prevalence of birth asphyxia was 5.3%. In addition to the known intrapartum complications, teenage motherhood, syphilis and a raised white blood cell count were associated with birth asphyxia. This indicates that for sustained reduction of birth asphyxia, appropriate management of maternal infections and improved intrapartum quality of care are essential.https://doi.org/10.1186/s12884-022-05095-yBirth asphyxiaSocio-demographic characteristicsTeenagersMaternal infectionsIntrapartum complicationsNorthern Uganda |
| spellingShingle | Elizabeth Ayebare Claudia Hanson Jolly Nankunda Anna Hjelmstedt Rebecca Nantanda Wibke Jonas James K. Tumwine Grace Ndeezi Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study BMC Pregnancy and Childbirth Birth asphyxia Socio-demographic characteristics Teenagers Maternal infections Intrapartum complications Northern Uganda |
| title | Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study |
| title_full | Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study |
| title_fullStr | Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study |
| title_full_unstemmed | Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study |
| title_short | Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study |
| title_sort | factors associated with birth asphyxia among term singleton births at two referral hospitals in northern uganda a cross sectional study |
| topic | Birth asphyxia Socio-demographic characteristics Teenagers Maternal infections Intrapartum complications Northern Uganda |
| url | https://doi.org/10.1186/s12884-022-05095-y |
| work_keys_str_mv | AT elizabethayebare factorsassociatedwithbirthasphyxiaamongtermsingletonbirthsattworeferralhospitalsinnorthernugandaacrosssectionalstudy AT claudiahanson factorsassociatedwithbirthasphyxiaamongtermsingletonbirthsattworeferralhospitalsinnorthernugandaacrosssectionalstudy AT jollynankunda factorsassociatedwithbirthasphyxiaamongtermsingletonbirthsattworeferralhospitalsinnorthernugandaacrosssectionalstudy AT annahjelmstedt factorsassociatedwithbirthasphyxiaamongtermsingletonbirthsattworeferralhospitalsinnorthernugandaacrosssectionalstudy AT rebeccanantanda factorsassociatedwithbirthasphyxiaamongtermsingletonbirthsattworeferralhospitalsinnorthernugandaacrosssectionalstudy AT wibkejonas factorsassociatedwithbirthasphyxiaamongtermsingletonbirthsattworeferralhospitalsinnorthernugandaacrosssectionalstudy AT jamesktumwine factorsassociatedwithbirthasphyxiaamongtermsingletonbirthsattworeferralhospitalsinnorthernugandaacrosssectionalstudy AT gracendeezi factorsassociatedwithbirthasphyxiaamongtermsingletonbirthsattworeferralhospitalsinnorthernugandaacrosssectionalstudy |