Majeed Rehana, Memon Yasmeen, Majeed Farrukh, Shaikh Naheed Parveen, Rajar Uzma D M
Department of Paediatrics, Isra University, Hyderabad.
J Ayub Med Coll Abbottabad. 2007 Jul-Sep;19(3):67-71.
Birth asphyxia is a serious clinical problem worldwide. There are many reasons a baby may not be able to take in enough oxygen before, during, or just after birth. Damage to brain tissues is a serious complication of low oxygen that can cause seizures and other neurological problems. This study was designed to asses the risk factors of birth asphyxia in neonates.
This descriptive, prospective study was conducted in the Department of Paediatrics, Isra University Hospital, Hyderabad, from April 2005 to April 2006. 125 newborn (75 males and 50 females) admitted to the neonatal care unit, who were delivered with delayed cry or low apgar score (< 7) were included. Detailed maternal history was taken, regarding their age, gestational age, and complications, if any.
Out of 125 neonatal encephalopathy cases, 28% were diagnosed as suffering with moderate or severe encephalopathy, whereas 36% had mild encephalopathy. Risk of neonatal encephalopathy increased with increasing or decreasing maternal age. Antepartum risk factors included non-attendance for antenatal care (64%). Multiple births increased risk in 4.8%. Intrapartum risk factors included non-cephalic presentation (20%), prolonged rupture of membranes (24%) and various other complications. Particulate meconium was associated with encephalopathy in 9.6%. 60% mothers were anemic. Vaginal bleeding was strongly associated with birth asphyxia in 34.44% of neonates. 56% of mothers delivered at home, while 28% delivered at a private hospital or maternity home. Only 12% delivered at a tertiary care hospital.
Lack of antenatal care, poor nutritional status, antepartum hemorrhage and maternal toxaemia were associated with higher incidence of asphyxia. Improvements in the public health of women with associated gains in female growth and nutrition must remain a longer-term goal. Early identification of high-risk cases with improved antenatal and perinatal care can decrease such high mortality. Safe motherhood policy is recommended.
出生窒息是全球范围内一个严重的临床问题。婴儿在出生前、出生时或出生后不久无法摄取足够氧气有多种原因。脑组织损伤是低氧的严重并发症，可导致癫痫发作和其他神经问题。本研究旨在评估新生儿出生窒息的危险因素。
这项描述性前瞻性研究于2005年4月至2006年4月在海得拉巴伊斯拉大学医院儿科进行。纳入新生儿重症监护病房收治的125名新生儿（75名男性和50名女性），这些新生儿出生时哭声延迟或阿氏评分低（<7分）。详细记录产妇病史，包括年龄、孕周以及是否有并发症。
在125例新生儿脑病病例中，28%被诊断为中度或重度脑病，而36%为轻度脑病。新生儿脑病的风险随着产妇年龄的增加或减少而增加。产前危险因素包括未进行产前检查（64%）。多胎妊娠使风险增加4.8%。产时危险因素包括胎位异常（20%）、胎膜早破时间延长（24%）以及各种其他并发症。胎粪污染与脑病的关联率为9.6%。60%的母亲贫血。34.44%的新生儿中，阴道出血与出生窒息密切相关。56%的母亲在家分娩，28%在私立医院或妇产医院分娩。只有12%在三级医疗机构分娩。
缺乏产前检查、营养状况差、产前出血和母体中毒与窒息发生率较高有关。改善女性公共卫生状况并相应提高女性生长发育和营养水平仍是一个长期目标。通过改善产前和围产期护理早期识别高危病例可降低此类高死亡率。建议实施安全孕产政策。
