Nauman Kiyani Asad, Khushdil Arshad, Ehsan Azra
Department of Pediatrics, Combined Military Hospital Multan, Pakistan.
Iran J Pediatr. 2014 Oct;24(5):637-42. Epub 2014 Sep 12.
To determine various perinatal factors leading to birth asphyxia among term newborns in a tertiary care hospital.
In a cross sectional study, a total of 196 asphyxiated cases were selected through consecutive non-probability sampling technique from neonatal intensive care unit (NICU) of a tertiary care Military Hospital in Pakistan from 1st December 2012 to 1st December 2013. Data obtained was analyzed using SPSS version 15.0. Descriptive statistics were used to calculate means, standard deviations and frequencies. Stratification with respect to maternal age, gestational age, newborns weight, parity and gravidity was done and post stratification chi-square test was applied to find statistical significance.
Out of 196 cases, 125 (64%) were males and 71 females (36%). Mean maternal age was 27.04+4.97 years and gestational age of babies was 39.86+1.24 weeks. Majority (57.14 %) of 112 mothers were 1-3 para and ≥4 parity was recorded in 84 (42.86%) cases. Majority (64.80%) of the 127 mothers were 1-3 gravida while 69 (35.20%) had ≥4 gravidity, mean of 3.45+0.87. Mode of delivery as a factor leading to birth asphyxia was found in 32.14% (n=63) cesarean section, 44.39% (n=87) spontaneous vertex delivery, and instrumental delivery in 23.47% (n= 46). Prolonged second stage of labor reported in 72% (n=141), 29.08% (n=57) had prolonged rupture of membranes, 7.65% (n=15) had meconium staining, 5.61% (n=11) had multiple births, 21.94% (n=43) had maternal fever, and 58.84% (n=113) had anemia at delivery.
Birth asphyxia is a preventable problem and long term neurological sequelae almost untreatable. Timely identification of the perinatal risk factors and their prompt solution can prevent and reduce the neonatal morbidity and mortality from birth asphyxia. Early identification of high-risk cases with improved antenatal and perinatal care can further decrease such high mortality.
确定一家三级医疗医院足月新生儿发生出生窒息的各种围产期因素。
在一项横断面研究中，采用连续非概率抽样技术，从2012年12月1日至2013年12月1日期间巴基斯坦一家三级医疗军事医院的新生儿重症监护病房（NICU）选取了196例窒息病例。使用SPSS 15.0版对获得的数据进行分析。描述性统计用于计算均值、标准差和频率。按母亲年龄、孕周、新生儿体重、产次和妊娠次数进行分层，并应用分层后卡方检验以发现统计学意义。
在196例病例中，125例（64%）为男性，71例女性（36%）。母亲平均年龄为27.04±4.97岁，婴儿孕周为39.86±1.24周。112位母亲中大多数（57.14%）为经产1 - 3次，84例（42.86%）记录为≥4次经产。127位母亲中大多数（64.80%）为妊娠1 - 3次，而69例（35.20%）妊娠≥4次，均值为3.45±0.87。作为导致出生窒息的一个因素，剖宫产分娩占32.14%（n = 63），自然头位分娩占44.39%（n = 87），器械助产占23.47%（n = 46）。72%（n = 141）报告第二产程延长，29.08%（n = 57）胎膜早破时间延长，7.65%（n = 15）有胎粪污染，5.61%（n = 11）为多胎妊娠，21.94%（n = 43）母亲发热，58.84%（n = 113）分娩时贫血。
出生窒息是一个可预防的问题，而长期神经后遗症几乎无法治疗。及时识别围产期危险因素并迅速解决可预防和降低出生窒息导致的新生儿发病率和死亡率。早期识别高危病例并改善产前和围产期护理可进一步降低此类高死亡率。
