Samara University, College of Medical and Health Sciences, Department of Public Health, Afar Region, Samara, Ethiopia.
College of Health Science, Amhara Region, Dessie, Ethiopia.
PLoS One. 2019 Dec 20;14(12):e0226891. doi: 10.1371/journal.pone.0226891. eCollection 2019.
Birth asphyxia is a leading cause of infant morbidity and mortality in developing nations, such as Ethiopia. Though Ethiopia has made considerable achievement in the reduction of under-five mortality rate, the neonatal mortality burden has not experienced the same reduction, which may be attributed to birth asphyxia. Thus, this study attempts to assess the prevalence and associated factors of birth asphyxia among newborns in public hospitals in the northeastern Amhara region, Ethiopia.
An institution-based cross-sectional study was conducted on 357 births from 1st April to 2nd May 2018. The sample size was proportionally allocated to randomly selected three public hospitals namely, Dessie referral hospital, Debre Berhan referral hospital, and Woldia general hospital. The allocation was made by taking the average number of deliveries given in each hospital six months before the data collection period. Using the delivery registration of hospitals a systematic random sampling technique was used to get all study participants. The diagnosis of birth asphyxia was confirmed based on the physician's diagnosis of an APGAR score < 7 in the 1st and 5th minutes of birth. A pretested and structured questionnaire was used to collect data. Variables with p-values < 0.25 in the bivariable analysis were entered into a multivariable logistic regression analysis. A statistical significant level was declared at a p-value of <0.05.
The prevalence of birth asphyxia was found to occur 22.6% of the time [95% CI 19.2% - 26.4%] in the first minute of birth. In the multivariable logistic regression being primipara [AOR = 3.77: 95% CI 1.86, 7.65], presented with complicated labor [AOR = 3.45: 95% CI 1.58, 7.49], premature rupture of membrane [AOR = 3.85: 95% CI 1.76, 8.44) and having blood-stained amniotic fluid at birth [AOR = 5.02: 95% CI 1.69, 14.87] were the independent predictors of birth asphyxia.
The study revealed that birth asphyxia is a common newborn complication in the Amhara region. Integrated mitigation measure to reduce neonatal mortality in the Amahar region should give due attention to primipara women and for these high-risk pregnancies in order for the region to achieve national and global commitment to have sustainable change in women and neonatal health.
出生窒息是发展中国家婴儿发病率和死亡率的主要原因，例如埃塞俄比亚。尽管埃塞俄比亚在降低五岁以下儿童死亡率方面取得了相当大的成就，但新生儿死亡率并没有同样降低，这可能归因于出生窒息。因此，本研究试图评估东北阿姆哈拉地区公立医院新生儿出生窒息的患病率及其相关因素。
这是一项 2018 年 4 月 1 日至 5 月 2 日进行的基于机构的横断面研究。样本量按比例分配给随机选择的三家公立医院，即德西转诊医院、德布雷伯汉转诊医院和沃尔迪亚综合医院。分配是通过在数据收集前六个月内每家医院的平均分娩量来进行的。使用医院的分娩登记，采用系统随机抽样技术获取所有研究参与者。根据医生在出生后 1 分钟和 5 分钟的 APGAR 评分<7 的诊断，确认出生窒息的诊断。使用经过预测试和结构化的问卷收集数据。在单变量分析中 p 值<0.25 的变量被纳入多变量逻辑回归分析。宣布具有统计学意义的水平为 p 值<0.05。
发现出生窒息的发生率在出生后 1 分钟时为 22.6%[95%CI 19.2% - 26.4%]。在多变量逻辑回归中，初产妇[优势比（AOR）=3.77：95%CI 1.86，7.65]、产程复杂（AOR=3.45：95%CI 1.58，7.49]、胎膜早破（AOR=3.85：95%CI 1.76，8.44）和出生时羊水血性（AOR=5.02：95%CI 1.69，14.87）是出生窒息的独立预测因素。
该研究表明，出生窒息是阿姆哈拉地区新生儿常见的并发症。为了实现国家和全球对妇女和新生儿健康的可持续性变革，减轻阿姆哈拉地区新生儿死亡率的综合缓解措施应特别关注初产妇，并关注这些高危妊娠。
