Factors Contributing to Birth Asphyxia in Newborn Babies at Mnazi-Mmoja Hospital in Zanzibar

Abstract

Background: Birth asphyxia continues to present a major clinical problem worldwide and becomes alarming which has long-term impacts on health outcomes in children‟s life. Birth asphyxia is the one of the commonest causes of neonatal morbidity and mortality in developing countries. Knowledge of factors contributing to birth asphyxia may prevent this fatal condition by regular assessment and monitoring of the progress of labor. Aim: The aim of this study was to assess factors contributing to birth asphyxia in newborn babies at Mnazi-Mmoja hospital (MMH) in Zanzibar. Materials and methods: Descriptive retrospective study design was used that employed quantitative approach. In this study, simple random sampling method was used, whereby, 399 files of pregnant mothers who delivered from Jan 2016 to March 2017 were reviewed; lottery method was used to select the sample size. Data abstraction forms were used to collect information from women‟s files; the following aspects were addressed: Social demographic characteristics (age, marital status, and mother‟s occupation), maternal factors (number of antenatal visits, parity, last antenatal records (Haemoglobin level, blood pressure, time of admission), existing maternal health problems, apgar score) and Institutional factors (frequency of Fetal Heart Rate (FHR) assessment, mode of delivery, birth attendants, frequency of contraction monitoring and vaginal examination). Results: A total of 144 (36%) out of 399 neonates were found to have birth asphyxia. Factors that were found to be statistical significant in contributing to birth asphyxia were prolonged labor (p=0.001), prematurity (p=0.000), improper fetal heart rate assessment (p=0.000), being delivered by doctors (p=0.000) and Vaginal delivery (p=0.000).Though, in logistic regression results revealed that vaginal delivery (95% CI: 3.372 – 14.747, p< 0.001), being delivered by midwife (95% CI: 0.901 – 2.511, p< 0.118) and prolonged labour (95% CI: O.374-1.163, p=0.151) contributing in birth asphyxia. However age, parity, mother‟s occupation, number of antenatal visits,existing maternal health problems, contraction monitoring and vaginal examination didn‟t show any statistical significant. Conclusion: Results show that most factors contributing to birth asphyxia are preventable if there is early identification of risk factors during antenatal care and intrapartum care. Recommendation: On job training on importance of regular assessment and monitoring of progress of labor and delivery is needed in order to ensure good outcome of the mothers and their babies so that to reduce or prevent birth asphyxia which cause most neonatal mortality rate.