Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi, Nigeria.
Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
BJOG. 2024 Aug;131 Suppl 3:88-100. doi: 10.1111/1471-0528.17816. Epub 2024 Apr 1.
To determine the incidence and sociodemographic and clinical risk factors associated with birth asphyxia and the immediate neonatal outcomes of birth asphyxia in Nigeria.
Secondary analysis of data from the Maternal and Perinatal Database for Quality, Equity and Dignity Programme.
Fifty-four consenting referral-level hospitals (48 public and six private) across the six geopolitical zones of Nigeria.
Women (and their babies) who were admitted for delivery in the facilities between 1 September 2019 and 31 August 2020.
Data were extracted and analysed on prevalence and sociodemographic and clinical factors associated with birth asphyxia and the immediate perinatal outcomes. Multilevel logistic regression modelling was used to ascertain the factors associated with birth asphyxia.
Incidence, case fatality rate and factors associated with birth asphyxia.
Of the available data, 65 383 (91.1%) women and 67 602 (90.9%) babies had complete data and were included in the analysis. The incidence of birth asphyxia was 3.0% (2027/67 602) and the case fatality rate was 16.8% (339/2022). The risk factors for birth asphyxia were uterine rupture, pre-eclampsia/eclampsia, abruptio placentae/placenta praevia, birth trauma, fetal distress and congenital anomaly. The following factors were independently associated with a risk of birth asphyxia: maternal age, woman's education level, husband's occupation, parity, antenatal care, referral status, cadre of health professional present at the birth, sex of the newborn, birthweight and mode of birth. Common adverse neonatal outcomes included: admission to a special care baby unit (SCBU), 88.4%; early neonatal death, 14.2%; neonatal sepsis, 4.5%; and respiratory distress, 4.4%.
The incidence of reported birth asphyxia in the participating facilities was low, with around one in six or seven babies with birth asphyxia dying. Factors associated with birth asphyxia included sociodemographic and clinical considerations, underscoring a need for a comprehensive approach focused on the empowerment of women and ensuring access to quality antenatal, intrapartum and postnatal care.
确定尼日利亚出生窒息的发生率以及与社会人口学和临床相关的危险因素，以及出生窒息的即刻新生儿结局。
对来自产妇和围产数据库质量、公平和尊严计划的数据进行二次分析。
尼日利亚六个地缘政治区域内的 54 家同意参与的转诊级医院（48 家公立和 6 家私立）。
2019 年 9 月 1 日至 2020 年 8 月 31 日期间在这些机构分娩的妇女（及其婴儿）。
对与出生窒息和即刻围产结局相关的流行率以及社会人口学和临床因素进行数据提取和分析。采用多水平逻辑回归模型确定与出生窒息相关的因素。
发生率、病死率和与出生窒息相关的因素。
在可获得的数据中，65383 名（91.1%）妇女和 67602 名（90.9%）婴儿有完整数据并纳入分析。出生窒息的发生率为 3.0%（2027/67602），病死率为 16.8%（339/2022）。出生窒息的危险因素包括子宫破裂、子痫前期/子痫、胎盘早剥/前置胎盘、分娩创伤、胎儿窘迫和先天性异常。以下因素与出生窒息的风险独立相关：产妇年龄、妇女的教育水平、丈夫的职业、产次、产前保健、转诊情况、分娩时在场的卫生专业人员的职称、新生儿性别、出生体重和分娩方式。常见的新生儿不良结局包括：入住新生儿特别护理病房（SCBU），88.4%；早发性新生儿死亡，14.2%；新生儿败血症，4.5%；呼吸窘迫，4.4%。
参与机构报告的出生窒息发生率较低，每 6 至 7 个婴儿中就有 1 个患有出生窒息，其中约有 1/6 或 1/7 死亡。与出生窒息相关的因素包括社会人口学和临床方面的考虑，这突显了需要采取全面的方法，重点是增强妇女权能，并确保获得优质的产前、分娩和产后护理。
