DETERMINANTS OF BIRTH ASPHYXIA AMONG NEWBORN LIVE BIRTHS IN PUBLIC HOSPITALS OF GAMO AND GOFA ZONES, SOUTHERN ETHIOPIA

Abstract

Introduction: Birth asphyxia is “the failure of a newborn to initiate and maintain breathing immediately at birth”. Globally, 2.5 million infants die within their first month of life every year, contributing nearly 47% of all deaths of children. It is the third cause of neonatal deaths next to infections and preterm birth. The effect of birth asphyxia is not only limited to common clinical problems and death; it also has a socio-economic impact on the families. Thus, identifying the determinants of birth asphyxia is an essential matter in enhancing neonatal quality of life. Therefore, this study intends to identify the determinants of birth asphyxia among newborn live births in public hospitals of Gamo & Gofa zones, Southern Ethiopia. Methods: An Institution based unmatched case-control study was conducted among newborn live births in public hospitals of Gamo & Gofa zones, with a total sample size of 356 (89 cases and 267 controls, 1:3 case to control ratio) from March 18 to June 18, 2021, after obtaining ethical clearance from Arba Minch University. Cases were selected consecutively and controls were selected by systematic random sampling method. Data were collected using a pretested semi-structured questionnaire through face-to-face interviews and record reviews using an extraction checklist for intrapartum & neonatal-related information. The collected data were entered into Epi data version 4.4 and exported to STATA version 14 for analysis. Finally, bi-variable and multivariable logistic regression analyses were performed to identify determinants of birth asphyxia. Statistical significance was declared at p-value ≤ 0.05 along with corresponding 95% CI of AOR used to declare statistical significance. Results: Anemia during pregnancy [AOR=3.87, 95% CI (1.06- 14.09)], breech presentation [AOR=3.56, 95% CI (1.19-10.65)], meconium stained amniotic fluid [AOR=6.16, 95% CI (1.95-19.46)], cord prolapse [AOR=4.69, 95%CI (1.04-21.05)], intrapartum fetal distress [AOR=9.83, 95% CI (3.82-25.25)] and instrumental delivery [AOR=5.91, 95% CI (1.51-23.07)] were significantly associated with birth asphyxia. Conclusion: Anemia during pregnancy, breech presentation, meconium-stained amniotic fluid, cord prolapse, intrapartum fetal distress, and instrumental delivery were identified as determinants of birth asphyxia. Thus, health professional and health institutions should give emphasis on care of mother and the newborn in actively detecting and managing asphyxia