Risk Factors Associated with Birth Asphyxia in Preterm Newborns: A Case Control Study

Safiullah; Muhammad Azhar Farooq; Usman Ghani; Muhammad Salman; Fatima Amir Cheeme; Roohullah

doi:10.70749/ijbr.v3i7.2652

Authors

Safiullah Department of Pediatrics, Services Hospital, Lahore, Pakistan
Muhammad Azhar Farooq Department of Pediatrics, Services Hospital, Lahore, Pakistan
Usman Ghani Department of Pediatrics, Lady Reading Hospital, Peshawar, Pakistan
Muhammad Salman Department of Pediatrics, Lady Reading Hospital, Peshawar, Pakistan
Fatima Amir Cheeme Department of Pediatrics, Services Hospital, Lahore, Pakistan
Roohullah Department of Pediatrics, Allied-2 Hospital, Faisalabad, Pakistan

DOI:

https://doi.org/10.70749/ijbr.v3i7.2652

Keywords:

Birth asphyxia, preterm newborns, risk factors, case-control study, neonatal outcomes

Abstract

Background: Birth asphyxia continues to be one of the most common causes of neonatal morbidity and mortality across the globe, especially among preterm infants who are more physiologically vulnerable. It remains one of the biggest problems in developing countries, such as Pakistan, regardless of the progress in obstetric care and neonatal care. Objective: The aim of the study was to determine maternal, obstetric, and neonatal risk factors linked to birth asphyxia in preterm infants at the Services Institute of Medical Sciences, Lahore. Methods: A case-control study was carried out in a hospital with unmatched cases between from 08 January 2025 to 08 June 2025. There were 240 preterm infants, of which 120 had asphyxia and 120 had no asphyxia. Primary data was gathered using maternal interviews, obstetric records, and neonatal examination. Logistic regression analysis was conducted to determine independent predictors of birth asphyxia. Results: Maternal age (age 30 years and above) (AOR=1.9, 95% CI: 1.13-3.5), no antenatal care (AOR=2.8, 95% CI: 1.6-4.9), preeclampsia (AOR=2.6, 95% CI: 1.25-5.7), prolonged labor (AOR=2.9, 95% CI: 1.5-5.6), and low birth weight (<2 kg) (AOR=3.5, 95% CI: 1.9–6.6). Protective factors were adequate antenatal care and risk aggravated by neonatal prematurity. Conclusion: Birth asphyxia in preterm infants is highly influenced by the maternal, obstetric and neonatal factors. Enhanced antenatal care coverage, early detection of high-risk pregnancies, proper monitoring of labor, and reinforcement of neonatal resuscitation services are critical measures that can be used to decrease the burden of asphyxia and improve neonatal survival in Pakistan.

Downloads

Download data is not yet available.

References

1. Alamneh YM, Negesse A, Aynalem YA, Shiferaw WS, Gedefew M, Tilahun M, Hune Y, Abebaw A, Biazin Y, Akalu TY. Risk factors of birth asphyxia among newborns at Debre Markos comprehensive specialized referral hospital, Northwest Ethiopia: unmatched case-control study. Ethiop J Health Sci. 2022;32(3).

https://doi.org/10.4314/ejhs.v32i3.6

2. Hassan SB, Rana SM, Hanif A, Gilani SA, Afzal S, Fatima W, Moazzam M, Ashraf T, Ayub T, Yaqoob M, Naeem M. Risk Factors Associated with Birth Asphyxia: A Case Control Study. Ann King Edward Med Univ. 2021;27(4):508-14.

https://doi.org/10.21649/akemu.v27i4.4883

3. Tegegnework SS, Gebre YT, Ahmed SM, Tewachew AS. Determinants of birth asphyxia among newborns in Debre Berhan referral hospital, Debre Berhan, Ethiopia: a case-control study. BMC Pediatr. 2022;22(1):165.

https://doi.org/10.1186/s12887-022-03223-3

4. Msisiri LS, Kibusi SM, Kimaro FD. Risk factors for birth asphyxia in hospital-delivered newborns in Dodoma, Tanzania: a case-control study. SAGE Open Nurs. 2024;10:23779608241246874.

https://doi.org/10.1177/23779608241246874

5. Kune G, Oljira H, Wakgari N, Zerihun E, Aboma M. Determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, Central Ethiopia: a case-control study. PLoS One. 2021;16(3):e0248504.

https://doi.org/10.1371/journal.pone.0248504

6. Jimma MS, Abitew KM, Chanie ES, GebreEyesus FA, Kelkay MM. Determinants of birth asphyxia among newborns in Northwest Ethiopia, 2019: case control study. Heliyon. 2022;8(2).

https://doi.org/10.1016/j.heliyon.2022.e08875

7. Tunta T, Dana T, Wolie A, Lera T. Determinants of birth asphyxia among neonates admitted to neonatal intensive care units in hospitals of the Wolaita zone, Southern Ethiopia: A case-control study. Heliyon. 2024;10(1).

https://doi.org/10.1016/j.heliyon.2023.e23856

8. Ahmed R, Mosa H, Sultan M, Helill SE, Assefa B, Abdu M, Ahmed U, Abose S, Nuramo A, Alemu A, Demelash M. Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: a systematic review and meta-analysis. PLoS One. 2021;16(8):e0255488.

https://doi.org/10.1371/journal.pone.0255488

9. Agbeko F, Kétévi AA, Fiawoo M, Tata BB, Abalo KE, Takassi EO, Douaguibe B, Akolly DA, Batalia HD, Djomaleu RA, Kérékou RB. Risk Factors for Birth Asphyxia in Togo: A Case-Control Study. Open J Pediatr. 2021;11(4):816-31.

https://doi.org/10.4236/ojped.2021.114077

10. Lake ES, Abita Z, Erega BB. Determinants of birth asphyxia among newborns in south Gondar Zone public hospitals, North West Ethiopia, 2021: A case control study. Heliyon. 2024;10(9).

https://doi.org/10.1016/j.heliyon.2024.e30093

11. Rattanaprom P, Ratinthorn A, Sindhu S, Viwatwongkasem C. Contributing factors of birth asphyxia in Thailand: a case–control study. BMC Pregnancy Childbirth. 2023;23(1):584.

https://doi.org/10.1186/s12884-023-05885-y

12. Fekede T, Fufa A. Determinants of birth asphyxia at public hospitals in Ilu Aba Bor zone southwest, Ethiopia: a case control study. Sci Rep. 2022;12(1):10705.

https://doi.org/10.1038/s41598-022-15006-y

13. Faridi TA. Risk Factors Associated with Birth Asphyxia: A Case Control Study.

https://doi.org/10.21649/akemu.v27i4.4883

14. Lemma K, Misker D, Kassa M, Abdulkadir H, Otayto K. Determinants of birth asphyxia among newborn live births in public hospitals of Gamo and Gofa zones, Southern Ethiopia. BMC Pediatr. 2022;22(1):280.

https://doi.org/10.1186/s12887-022-03342-x

15. Roto S, Nupponen I, Kalliala I, Kaijomaa M. Risk factors for neonatal hypoxic ischemic encephalopathy and therapeutic hypothermia: a matched case-control study. BMC Pregnancy Childbirth. 2024;24(1):421.

https://doi.org/10.1186/s12884-024-06596-8

16. Kebede E, Kekulawala M. Risk factors for stillbirth and early neonatal death: a case-control study in tertiary hospitals in Addis Ababa, Ethiopia. BMC Pregnancy Childbirth. 2021;21(1):641.

https://doi.org/10.1186/s12884-021-04025-8

17. Torres-Muñoz J, Fonseca-Perez JE, Laurent K. Biological and Psychosocial Factors, Risk Behaviors, and Perinatal Asphyxia in a University Hospital: Matched Case–Control Study, Cali, Colombia (2012–2014). Front Public Health. 2021;9:535737.

https://doi.org/10.3389/fpubh.2021.535737

18. Su YJ, Liu W, Xing RR, Yu ZB, Peng YM, Luo WX. Prevalence and risk factors associated with birth asphyxia among neonates delivered in China: a systematic review and meta-analysis. BMC Pediatr. 2024;24(1):845.

https://doi.org/10.1186/s12887-024-05316-7

19. Ayebare E, Hanson C, Nankunda J, Hjelmstedt A, Nantanda R, Jonas W, Tumwine JK, Ndeezi G. Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study. BMC Pregnancy Childbirth. 2022;22(1):767.

https://doi.org/10.1186/s12884-022-05095-y

20. Getachew T, Tadesse M, Batu D, Gebre DS, Tololu AK, Bayou H, Simie H. Determinants of Birth Asphyxia among New Born Babies in Bekoji Public Hospital, Arsi Zone, Oromia Regional State, Ethiopia, 2023 Unmatched case control study design. J Pediatr Neonatal Care. 2024;14(2):95-103.

https://doi.org/10.21203/rs.3.rs-3996136/v1

21. Sunny AK, Paudel P, Tiwari J, Bagale BB, Kukka A, Hong Z, Ewald U, Berkelhamer S, Ashish KC. A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal. BMC Pediatr. 2021;21(1):394.

https://doi.org/10.1186/s12887-021-02858-y