Factors Related to Adverse Outcome in Asphyxiated Babies:

Abstract

To determine the selected antenatal and perinatal risk factors (weight, sex, gestational age, maternal age, parity, mode of delivery, place of delivery, age at arrival and stage of hypoxic ischemic encephalopathy) for adverse outcome in babies with birth asphyxia, at Sir Ganga Ram Hospital, Lahore. This was an observational study conducted in a prospective manner in the neonatology unit of the department of Paediatrics, Fatima Jinnah Medical College/Sir Ganga Ram Hospital, Lahore, over a period of six months from 1^st August, 2007 to 31^st Jan. 2008. This study included 144 consecutive asphyxiated neonates who were admitted in our neonatal unit and fulfilled the inclusion criteria. Detailed maternal information, physical examination and progress of the babies were noted regularly till the time of death or discharge and entered into a specified proforma. Babies were categorized into different stages of HIE (Hypoxic Ischemic Encephalopathy) according to Sarnat and Sarnat staging. On the basis of outcome, they were divided into two groups, group one who survived and were discharged with stable vital signs and group two, who died. Effect of risk factors on both groups were compared and results were expressed as (P<0.05 was taken significant) by using chi-square test.

Results:  Total admissions during the study period were 650. One hundred and forty four (22%) suffered birth asphyxia. Out of one hundred and forty four asphyxiated babies forty five (31.3%) were females and ninety nine (68.8%) were males. Ninety three (64.6%) weighed >2.5 kg and fifty one (35.4%) 1.5-2.5 kg. 15 (10.4%) babies of birth asphyxia did not suffer HIE, 53(36.8%) had stage I, 46 (32.0%) stage II and 30 (20.8%) stage III HIE. 86 (59.7%) of the babies were discharged successfully and 58 (40.3%) died. Variables (risk factors) found significantly affecting adverse outcome were late arrival and severe birth asphyxia.

Conclusion:  Referring high risk pregnancies to tertiary care hospitals is not enough because these centers and neonatal units have their own limitations so more attention should be paid to prevention.

Key words:  Birth Asphyxia, Hypoxic Ischemic Encephalopathy, Adverse outcome.