Velaphi S, Pattinson R
Department of Paediatrics, University of Witwatersrand, Johannesburg, South Africa.
Ann Trop Paediatr. 2007 Jun;27(2):99-106. doi: 10.1179/146532807X192462.
Fetal or neonatal hypoxia owing to asphyxia can result in death or severe irreversible brain damage. To prevent this, factors contributing to the development of fetal or neonatal hypoxia must be identified.
To determine the primary obstetric and neonatal causes or diagnoses and avoidable factors associated with death from asphyxia-hypoxia.
Data from a computerised database from 142 hospitals using the Perinatal Problem Identification Program in South Africa from October 1999 to September 2003 were analysed. All records of deaths from asphyxia-hypoxia were retrieved and analysed. Primary obstetric and neonatal causes or diagnoses and factors associated with these deaths were identified. Each case identified as having died from asphyxia-hypoxia was analysed for possible and probable avoidable factors.
Among 4502 neonatal deaths weighing >999 g, 1459 (32.4%) were identified as being related to asphyxia-hypoxia. Intrapartum asphyxia was the most common diagnosis (72% of deaths). Hypoxic-ischaemic encephalopathy was identified as the main neonatal diagnosis in these deaths. The most common category of probable avoidable factors was health worker-related. Inadequate fetal monitoring was the most common health worker-related probable avoidable factor. Substandard care related to resuscitation was recorded infrequently, most likely because of inability to assess neonatal resuscitation.
Asphyxia-hypoxia is responsible for about one-third of neonatal deaths. Intrapartum asphyxia is the major primary obstetric cause of deaths from hypoxia. A third of the deaths were judged to be preventable.
因窒息导致的胎儿或新生儿缺氧可造成死亡或严重的不可逆脑损伤。为预防这种情况，必须确定导致胎儿或新生儿缺氧的因素。
确定与窒息 - 缺氧死亡相关的主要产科和新生儿病因或诊断以及可避免因素。
分析了1999年10月至2003年9月期间南非142家医院使用围产期问题识别程序的计算机数据库中的数据。检索并分析了所有窒息 - 缺氧死亡记录。确定了主要的产科和新生儿病因或诊断以及与这些死亡相关的因素。对每例被确定为因窒息 - 缺氧死亡的病例分析可能和很可能的可避免因素。
在体重>999克的4502例新生儿死亡中，1459例（32.4%）被确定与窒息 - 缺氧有关。产时窒息是最常见的诊断（占死亡病例的72%）。缺氧缺血性脑病被确定为这些死亡中的主要新生儿诊断。最常见的很可能可避免因素类别与卫生工作者有关。胎儿监测不足是最常见的与卫生工作者有关的很可能可避免因素。与复苏相关的不合格护理记录较少，很可能是因为无法评估新生儿复苏情况。
窒息 - 缺氧导致约三分之一的新生儿死亡。产时窒息是缺氧死亡的主要产科病因。三分之一的死亡被判定为可预防的。
