Perinatal asphyxia: multivariate analysis of risk factors in hospital births.
OBJECTIVE
To determine risk factors for perinatal asphyxia.


METHODS
Cohort study.


METHODS
Teaching hospital.


METHODS
All consecutive hospital births were evaluated during the study period. Asphyxia was defined on intrapartum and neonatal resuscitation criteria. Maternal, intrapartum and neonatal variables were recorded in all births. Data was analyzed after stratifying for live and stillbirths by univariate and logistic regression analyses.


RESULTS
Amongst 2371 births (55 fetal deaths and 2316 live births), there were 86 cases of perinatal asphyxia (35 fetal deaths and 51 live births), providing an asphyxia rate of 36.3/1000 births. On multivariate analysis, risk factors significantly associated with asphyxia included prolonged second stage labor (OR 9.4), vaginal breech delivery (OR 6.6), elective cesarean delivery (OR 4.6), pregnancy induced hypertension (PIH) (OR 2.7) and fetal growth retardation (SFD) (OR 2.4). Amongst stillborn, the significant univariate factors associated with asphyxia were prolonged second stage labor (RR 1.7) and cord prolapse (RR 1.7).


CONCLUSIONS
There is a need to strengthen intrapartum management and early identification of mothers with PIH or intrauterine growth retardation to reduce asphyxial morbidity and mortality.
Chandra
S
S
Department of Pediatrics, Maulana Azad Medical College, New Delhi.
Ramji
S
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Thirupuram
S
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D001238:Asphyxia Neonatorum / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D002423:Cause of Death; D015331:Cohort Studies; D003906:Developing Countries; D005260:Female; D005313:Fetal Death; D017052:Hospital Mortality; D006801:Humans; D007194:India / Q000453:epidemiology; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D012307:Risk Factors