Burden and Outcomes of Birth Asphyxia in Neonates Admitted to the Neonatal Intensive Care Unit of The Tamale Teaching Hospital

Abstract

Objective: The aim of this study was to determine the burden, outcomes and factors associated with outcomes of birth asphyxia among sick neonates admitted to the Neonatal Intensive Care Unit (NICU) of the Tamale Teaching Hospital (TTH).
Patients and Methods: A retrospective descriptive study design was used. Subjects included all neonates admitted to the unit with diagnosis of birth asphyxia, during the study period (January 2018-December 2019), who met the inclusion criteria. Descriptive statistics were presented in tables and graphs. Multiple logistic regression was used to identify independent predictors of mortality.
Results: The prevalence of birth asphyxia was 17.6% of admissions. There were more males (594,60.3%) than females and most (707,74.3%) of the cases seen were inborn. Majority (617,63.3%) were delivered via spontaneous vaginal delivery. APGAR scores ≤ 3 was
seen in 259(26.3%) of the babies. The case fatality rate was 14.9% and more than half (78,53%) occurred within the first 24 hours of admission. Outborn babies were 2.7 times more likely to die from birth asphyxia compared to inborn babies(p-value=<0.001). Babies with APGAR scores ≤ 3 were 3.9 times more likely to die compared to babies with APGAR scores 4-6 at one minute, (pvalue=<
0.001) and babies born to mothers < 20 years of age were 2 times more likely to die as compared to older mothers (p-value=0.048).
Conclusions: Birth asphyxia is common in our facility. Outborn babies, babies with one-minute APGAR score ≤3, and maternal age < 20 years were significantly associated with mortality.