title: Clinical Profile of Neonates with Perinatal Asphyxia in a Tertiary Care Hospital of Central Nepal.
abstract: BACKGROUND
  Birth asphyxia is a serious clinical problem worldwide. It claims approximately 9 million deaths each year. It can lead to serious neurological sequaele, such as cerebral palsy, mental retardation, and epilepsy.
  
  
  METHODS
  All babies admitted in College of Medical Sciences Teaching Hospital, Chiwan, Nepal, NICU from January 2013 to December 2013 with a diagnosis of birth asphyxia (5 min Apgar<7 or those with no spontaneous respirations after birth) were included in the study (n=125). This was a descriptive observational study. Clinical information was collected (gravida, hour at presentation, mode of delivery, sex of baby, gestational age of the baby, requirement of resuscitation). Neonates were admitted to NICU, observed for complications and managed as per hospital protocol.
  
  
  RESULTS
  Among the 722 neonates admitted to NICU, 125 had perinatal asphyxia (17.3%). Babies with Hypoxic ischemic encephalopathy(HIE) Grade I had a very good outcome but HIE III was associated with a poor outcome. Outborn neonates had higher grades of perinatal asphyxia as compared to inborns (p=0.018). Term gestation, Males and Multigravida were associated with a higher rate of birth asphyxia. 22.4% neonates were delivered via caesarean section and 74.4% required bag and mask ventilation at birth.
  
  
  CONCLUSIONS
  Birth asphyxia was one of the commonest causes of admission NICU. Babies with HIE Grade III had a very poor prognosis. Outborn neonates with birth asphyxia had a higher mortality. Males were frequently affected than females.
authors.affiliation: Department of Pediatrics, College of Medical Sciences, Bharatpur, Chitwan, Nepal.
authors.forename: S K
authors.initials: SK
authors.lastname: Gupta
authors.affiliation: Department of Pediatrics, College of Medical Sciences, Bharatpur, Chitwan, Nepal.
authors.forename: B K
authors.initials: BK
authors.lastname: Sarmah
authors.affiliation: Department of Pediatrics, College of Medical Sciences, Bharatpur, Chitwan, Nepal.
authors.forename: D
authors.initials: D
authors.lastname: Tiwari
authors.affiliation: Department of Pediatrics, College of Medical Sciences, Bharatpur, Chitwan, Nepal.
authors.forename: A
authors.initials: A
authors.lastname: Shakya
authors.affiliation: Department of Community Medicine, College of Medical Sciences, Bharatpur, Chitwan, Nepal.
authors.forename: D
authors.initials: D
authors.lastname: Khatiwada
mesh_terms: D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D009390:Nepal; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers
keywords: birth asphyxia; HIE; mortality; measurement.