Alsharif Afaf, Almatary Abdullah M, Ahmed Faisal, Badheeb Mohamed
Gynecology, Jibla University for Medical and Health Sciences, Ibb, YEM.
General Surgery, Jibla University for Medical and Health Sciences, Ibb, YEM.
Cureus. 2024 Feb 12;16(2):e54100. doi: 10.7759/cureus.54100. eCollection 2024 Feb.
Birth asphyxia is a major cause of infant death across the world, especially in developing countries, where the issue is significantly underreported and underestimated, particularly in fragile and conflict-affected states.
The purpose of this study was to determine the prevalence and risk factors for birth asphyxia in women at Jiblah University Hospital in Ibb, Yemen, and its predictive factors throughout six years of conflict.
We conducted a retrospective cross-sectional chart review and analysis of the birth database spanning from June 2013 to September 2019 at Jiblah University Hospital in Ibb, Yemen. We used APGAR (appearance, pulse, grimace, activity, and respiration) scores <7 at both the first- and fifth-minute post-delivery with umbilical cord arterial blood pH <7 (metabolic acidosis) and/or neurologic manifestations (seizures or an altered tone) within the first 24 hours of life to define birth asphyxia cases. Factors associated with birth asphyxia were analyzed using univariate and multivariate regression analysis with an odds ratio (OR) and 95% confidence interval (CI).
A total of 5,193 neonates were delivered during the study period. The prevalence of birth asphyxia in 309 (6%) neonates. In a multivariate analysis, illiteracy (OR: 2.90; 95% CI: 0.98-8.41), referred mothers (OR: 3.04; 95% CI: 1.42-6.40), advanced maternal age (OR: 1.05; 95% CI: 1.02-1.07), home delivery (OR: 6.50; 95% CI: 3.09-12.57), prematurity (OR: 1.43; 95% CI: 1.05-1.93), and low birth weight (OR: 3.09; 95% CI: 1.93-4.93) were predictors for birth asphyxia and were statistically significant (p<0.05).
In this study, the prevalence of birth asphyxia was equivalent to that of other underdeveloped nations. However, continual attention and treatments are required to lower the risk of birth asphyxia. Illiteracy, referred mothers, advanced maternal age, home delivery, prematurity, and low birth weight were all predictors of birth asphyxia in this research. Most birth asphyxia factors mentioned in this study can be managed through effective prenatal, intrapartum, and postpartum care, as well as a strict following of national obstetrics and neonatal guidelines.
出生窒息是全球婴儿死亡的主要原因，在发展中国家尤为如此，在这些国家，该问题的报告严重不足且被低估，在脆弱和受冲突影响的国家更是如此。
本研究的目的是确定也门伊卜省吉卜拉大学医院分娩女性中出生窒息的患病率和危险因素，以及在六年冲突期间其预测因素。
我们对也门伊卜省吉卜拉大学医院2013年6月至2019年9月的出生数据库进行了回顾性横断面图表审查和分析。我们使用出生后第一分钟和第五分钟时阿氏（外观、脉搏、 grimace、活动和呼吸）评分<7，脐动脉血pH<7（代谢性酸中毒）和/或出生后24小时内出现神经学表现（癫痫发作或肌张力改变）来定义出生窒息病例。使用单因素和多因素回归分析以及比值比（OR）和95%置信区间（CI）分析与出生窒息相关的因素。
在研究期间共分娩了5193例新生儿。309例（6%）新生儿发生出生窒息。在多因素分析中，文盲（OR：2.90；95%CI：0.98 - 8.41）、转诊产妇（OR：3.04；95%CI：1.42 - 6.40）、高龄产妇（OR：1.05；95%CI：1.02 - 1.07）、在家分娩（OR：6.50；95%CI：3.09 - 12.57）、早产（OR：1.43；95%CI：1.05 - 1.93）和低出生体重（OR：3.09；95%CI：1.93 - 4.93）是出生窒息的预测因素，且具有统计学意义（p<0.05）。
在本研究中，出生窒息的患病率与其他不发达国家相当。然而，需要持续关注和治疗以降低出生窒息的风险。在本研究中，文盲、转诊产妇、高龄产妇、在家分娩、早产和低出生体重都是出生窒息的预测因素。本研究中提到的大多数出生窒息因素可通过有效的产前、产时和产后护理以及严格遵循国家产科和新生儿指南来控制。
