Socio-clinical correlates of the perinatal outcome of severe perinatal asphyxia among referred newborn babies in Sagamu

Abstract

Background: Most deliveries in the developing world take place outside the hospital with poor assistance for the newborn. This puts the babies at risk of severe intrapartum events such as perinatal asphyxia. Most newborn babies admitted in tertiary centres with severe asphyxia are referred. Objectives: To determine the socio-demographic and clinical correlates of the perinatal outcome of neonates referred to a Nigerian tertiary facility on account of severe perinatal asphyxia. Methods: A prospective cross- sectional study was conducted at the Children’s Emergency Room and Neonatal Ward among newborn babies referred with severe asphyxia. Socio-demographic and clinical parameters were recorded and statistically analysed. Results: A total of 72 mother infant pairs were studied. Half of the babies were admitted after 24 hours of birth and 75.0% of the families belonged to the lower socio-economic classes. Only 62.5% of mothers received antenatal care at orthodox health facilities. Most of the deliveries took place at private hospitals (29; 40.3%) and Traditional Birth Homes (18; 25.0%). HypoxicIschaemic encephalopathy (HIE) was diagnosed among 57 (79.2%) babies with 46 (80.7%) and 11 (19.3%) classified as Stages II and III HIE respectively. There were 15 (20.8%) early neonatal deaths giving a perinatal mortality rate of 208.3/1000 admissions. The poor perinatal outcome was associated with age at admission within 24 hours, poor intrapartum care- seeking behaviour and the commencement of feeding before admission. Conclusion: The quality of antenatal care, intrapartum care, and delivery services appear to influence perinatal outcomes among referred babies with severe asphyxia.

Keywords

• asphyxia
• hypoxicischaemic encephalopathy
• intra- partum care
• perinatal mortality
• out-born