Prevalence, case fatality rate and risk factors for mortality among neonates admitted with perinatal asphyxia at a tertiary hospital in northern Nigeria

Abstract

Documenting the burden and the risk factors for perinatal asphyxia-related mortality is key to its prevention. The goal was to document the factors associated with mortality in perinatal asphyxia in a tertiary health facility in Nigeria. Records of consecutive neonatal admissions (between January 2016 and January 2017) underwent a retrospective analysis. Data were analyzed using Stata statistical software version 16 (Statacorp® Texas, USA). 102 (12.1%) of 841 admitted neonates had perinatal asphyxia; the median age (inter quartile range [IQR]) was 6 (0-168) hours. The mean admission weight ±(SD) was 2.96kg±(0.66) kg. Among inborn neonates, the incidence was 9.7 per 1000 live births. In 49% (50/102) pregnancies the amniotic fluid was clear; in 42% (43/102) it was meconium-stained; and 9 staining was unreported. Case fatality rate was 20.6% (21 of 102). 77(75%) neonates had no HIE, while 24 (24.5%) did. When compared to neonates without HIE, those with HIE II had about 7000 times higher odds of mortality (aOR = 68132.19, P0.01, 95% CI 3 to 1.4X 109). The adjusted odds of mortality for neonate with meconium-stained liquor were about 1900 times higher compared to clear meconium (aOR =1895, P = 0.02, 95%CI = 2.7 to 13072). Neonates with higher mean admission lengths (49.4cm [range = 48.8 to 50]) had 88 times lower odds of death compared to shorter neonates (aOR of 0.12 (95% CI: 0.17 to 0.85; p = 0.03).