<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Birth Asphyxia (BA) is one of the leading causes of neonatal death in develo...<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Birth Asphyxia (BA) is one of the leading causes of neonatal death in developing countries. In Togo, 30.55% of neonatal deaths were related to BA and caused by several risk factors. The purpose of this piece of work is to analyse the antepartum, intrapartum, and foetal risk factors of BA. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is a case control study, conducted from 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> December 2019 to 28</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> February 2020 in obstetrics wards and at neonatal intensive care of paediatric ward at the Sylvanus Olympio university teaching hospital (CHU-SO) in Lomé, Togo. Neonates diagnosed with BA (Apgar score < 7 at 5</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> minute) were considered as “cases” (N = 200) while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as “control” (N = 200). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The prevalence rate of BA was 9.13%. Age (p = 0.0391), gravidity (p = 0.0040), type of facility for prenatal follow-up (p < </span></span><span style="font-family:Verdana;">0.0001), use of Long-lasting impregnated mosquito nets (LLIN) (p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), notion of maternal fever (p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001) </span><span style="font-family:Verdana;">and chronic pathology (p < </span><span style="font-family:Verdana;">0.0001) were related to occurrence of BA. Significant antepartum risk factors observed were age < 25 years (OR = 1.15;CI 95% [0.66 - 1.98], p = 0.0391), primigravidity (OR = 1.82;95% CI [0.86 - 3.85], 0.0040), prenatal follow-up in a</span><span style="font-family:Verdana;"> private one (OR = 1.62;CI95% [1.03 - 12.55], p < </span><span style="font-family:Verdana;">0.0001), non-use of LLIN (OR = 2.50;CI 95% [1.61 - 3.88], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), maternal fever (OR = 3.73;CI 95% [2.33 - 5.97], p < 0.0001) and existence of maternal chronic pathology (OR = 36.0, 95% [4.94 - 262.60], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0</span><span style="font-family:Verdana;">001). Significant intrapartum risk factors were PRM (OR = 7.89;CI 95% [2.62 - 14.02], p < </span><span style="font-family:Verdana;">0.0001), abnormal AF (OR = 5.40;CI 95% [2.57 - 11.38],], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), long labour (OR = 2.11;CI 95% [1.34 - 3.34],], p = 0.0004), use of oxytocin (OR = 2.14;CI 95% [1.3</span><span style="font-family:Verdana;">8 - 3.32], p = 0.0003), and spontaneous vaginal (OR = 1.76;CI 95% [1.14 - 2.72,], p = 0.0008]). Significant Foetal risk factors were male gender (OR = 1.55;CI 95% [1.03 - 2.33], p = 0.0423), preterm babies (OR = 8.83;CI 95% [3.79 - 20.60], p < </span><span style="font-family:Verdana;">0.0001) and baby </span><span style="font-family:Verdana;">birth weight < 2500 gr (OR = 2.96;CI 95% [1.82 - 4.79], p < </span><span style="font-family:""><span style="font-family:Verdana;">0.0001). The Sarnat score had shown anoxo-ischemic encephalopathy stage III (19.00%), corresponding to 87.80% of case fatality rate (p < 0.0001). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Various risk factors lead to BA in Lomé. </span></span><span style="font-family:Verdana;">Early identification of high-risk cases with improved antenatal and perinatal care can decrease the high mortality of BA in Togo.</span>展开更多
Objective:To evaluate the utilization of antenatal services by mothers of babies delivered with severe birth asphyxia at the University of Port Harcourt Teaching Hospital(UPTH) Port Harcourt,Nigeria.Methods: A case co...Objective:To evaluate the utilization of antenatal services by mothers of babies delivered with severe birth asphyxia at the University of Port Harcourt Teaching Hospital(UPTH) Port Harcourt,Nigeria.Methods: A case control study of the utilization of antenatal services by 97 mothers of newborns with severe birth asphyxia delivered at UPTH from 1st February to 31st October 2009 compared with mothers of newborns with normal Apgar scores was done.Relevant pregnancy,birth,family and social history was obtained by personal interviews and referral to case notes.Results: Significantly more of the mothers of babies with normal Apgar score booked early(4 months or less) and had up to 8 or more antenatal visits prior to delivery than mothers of asphyxiated babies 86(88.6%) vs 68(70.2%),P=0.002;93(95.7%) vs 68(70.2%),P=0.001 respectively.Significantly more subjects 56(57.7%) than the controls 45(46.4%) were primiparous,P= 0.04.Also,significantly more subjects 19(19.5%) suffered delay prior to intervention in labour than the controls 5(5.1%),P=0.004.Conclusion: Primiparity,delayed booking,inadequate antenatal visits and late intervention in labour have been identified as significant contributors to severe birth asphyxia.展开更多
Background: Birth asphyxia is one of the major causes of neonatal deaths worldwide. Queen Elizabeth Central Hospital (QECH) neonatal ward records indicate that 36.5% of neonates admitted in the ward from April to Sept...Background: Birth asphyxia is one of the major causes of neonatal deaths worldwide. Queen Elizabeth Central Hospital (QECH) neonatal ward records indicate that 36.5% of neonates admitted in the ward from April to September 2012 had birth asphyxia. This study was conducted to explore associative factors for birth asphyxia at QECH. Methodology: The study design was descriptive cross sectional that employed quantitative methods of data collection and analysis. Data sources were case notes of neonates and their mothers.? Sample size was 87 neonates with birth asphyxia and 87 neonates admitted with conditions other than birth asphyxia as controls. Data were collected from November to December 2013. Statistical Package for Social Science (SPSS) version16.0 was used to analyze data. Results: Findings revealed that there were no maternal associative factors for birth asphyxia, however, foetal distress, prolonged first and second stage of labour were significant associative factors for birth asphyxia. Conclusion: Associative factors for birth asphyxia at QECH are Foetal distress, prolonged first and second stage of labour. These factors can be prevented if quality care is provided to women in labour through close monitoring of foetal heart, appropriate use of the partograph, prompt decision making and early interventions.展开更多
Background: During the past two decades there has been a sustained decline in child mortality;however, neonatal mortality has remained stagnant. Each year approximately 4 million babies are born asphyxiated resulting ...Background: During the past two decades there has been a sustained decline in child mortality;however, neonatal mortality has remained stagnant. Each year approximately 4 million babies are born asphyxiated resulting in 2 million neonatal deaths and intrapartum stillbirths. Almost all neonatal deaths occur in developing countries, where the majority is delivered at homes with negligible antenatal care and poor perinatal services. Objectives: To identify socio-demographic and clinical risk factors associated with birth asphyxia in Matiari District of Sindh Province, Pakistan. Method: A matched case control study was conducted in Matiari District with 246 cases and 492 controls. Newborn deaths with birth asphyxia diagnosed through verbal autopsy accreditation during 2005 and 2006 were taken as cases. Controls were the live births during the same period, matched on area of residence, gender and age. Result: The factors found to be associated with birth asphyxia mortality in Matiari District of Sindh Province, Pakistan are maternal education, history of stillbirths, pregnancy complications (including smelly or excessive vaginal discharge and anemia), intrapartum complications (including fever, prolong or difficult labour, breech delivery, cord around child’s neck, premature delivery, large baby size) and failure to establish spontaneous respiration after birth. Conclusion and Recommendation: There is an immediate need to develop strategies for early identification and management of factors associated with birth asphyxia by involving women, families, communities, community health workers, health professionals and policy makers. Community health workers should be trained for emergency obstetric care, basic newborn care including preliminary resuscitation measures to provide skilled birth attendance and encourage early recognition and referral.展开更多
A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional us...A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional using quantitative data analysis method on 75 midwives that were working in the maternity unit of the hospital. A structured questionnaire was used to collect data on participant’s demographic characteristics and midwives’ comprehension of birth asphyxia and an observational check list was used to observe midwives’ adherence to WHO resuscitation guidelines. In addition midwives were observed on their adherence to the Integrated Maternal and Neonatal Health guidelines that were developed by the Malawi Ministry of Health. The findings indicate that the midwives had knowledge of birth asphyxia in general. However, there were gaps in their ability to identify warning signs of birth asphyxia through partograph use. In addition the midwives did not adhere to 9 out of the 21 steps of the resuscitation guideline. Generally there was substandard adherence to guidelines on identification of warning signs of birth asphyxia and neonatal resuscitation. On the other hand, the facility did not have adequate resuscitation equipment and supplies. The results are discussed in relation to the importance of adhering to resuscitation guidelines in the management of birth asphyxia for babies that do not breathe at birth. Training of the midwives on partograph use and resuscitation to improve neonatal outcomes is recommended. It is recommended further that the health facility should have adequate resuscitation equipment and supplies.展开更多
Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-co...Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1st to June 30th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.展开更多
目的探讨出生窒息早产儿纠正胎龄34周振幅整合脑电图(aEEG)评分差异及与Apgar评分、新生儿20项行为神经测定(NBNA)评分的相关性。方法回顾性选取2022年2月至8月在广州医科大学附属第二医院新生儿重症监护室(NICU)收治的早产儿,依据Apga...目的探讨出生窒息早产儿纠正胎龄34周振幅整合脑电图(aEEG)评分差异及与Apgar评分、新生儿20项行为神经测定(NBNA)评分的相关性。方法回顾性选取2022年2月至8月在广州医科大学附属第二医院新生儿重症监护室(NICU)收治的早产儿,依据Apgar评分将其分为无窒息组、轻度窒息组以及重度窒息组。纠正胎龄34周时进行aEEG监测并运用Burdjalov评分系统评估脑发育成熟度。比较三组的aEEG各参数评分及总分;采用Spearman相关性分析探讨aEEG总分与Apgar评分以及纠正胎龄42周NBNA评分的相关性。结果重度窒息组的aEEG连续性、下边界振幅评分及总分均低于无窒息组(P<0.05);重度窒息组的下边界振幅评分低于轻度窒息组(P<0.05)。重度窒息组5 min Apgar评分与aEEG总分呈正相关(r=0.56,P=0.03)。重度窒息组纠正胎龄42周NBNA评分与aEEG总分呈正相关(r=0.91,P=0.01)。结论纠正胎龄34周的aEEG综合评分与重度窒息早产儿5 min Apgar评分有显著的相关性,aEEG综合评分可用于早期评估该类患儿的脑功能。展开更多
Perinatal asphyxia is defined as harm to the fetus or the newborn caused by hypoxia and/or ischemia of various organs with intensity to produce biochemical and/or functional changes. Understanding the risk factors for...Perinatal asphyxia is defined as harm to the fetus or the newborn caused by hypoxia and/or ischemia of various organs with intensity to produce biochemical and/or functional changes. Understanding the risk factors for this clinical condition allows the identification of vulnerable groups, enabling an improvement in care planning in the perinatal period in neonatal intensive care units. In this sense, this research aimed to identify risk factors for perinatal asphyxia present in newborns term that showed record for this clinical condition. This was a cross-sectional, retrospective documentary, quantitative and descriptive, conducted from data from medical records of 55 infants admitted to a neonatal intensive care unit. As for maternal characteristics (78.0%) had between 16 and 35 years, only one child (53.0%) and (76.0%) had no prior history of miscarriage. As for pre-existing diseases or pregnancy (38.0%) developed by Hypertensive Pregnancy Specific disease (02.0%) were suffering from Hypertension and (02.0%) of Diabetes Mellitus. As for newborns, most infants had birth weight (43.6%) and correlation with gestational age (78.2%) compatible for good conditions of birth. Only (20.0%) of the infants had a difficult labor. It stood out although there was a slight predominance of severe asphyxia (50.9%) in the first minute and (45.5%) of the infants had record release intrauterine meconium. It was concluded that most mothers and newborns did not have risk factors for perinatal asphyxia, thus, this fact could be attributed to the structural conditions of service, especially in the care during labor, delivery and immediate assistance newborn.展开更多
目的分析1990—2019年我国出生窒息/创伤所致新生儿脑病的疾病负担水平及其变化趋势。方法从2019年全球疾病负担研究数据库中提取1990—2019年我国出生窒息/创伤所致新生儿脑病的伤残调整寿命年(disability-adjusted life years,DALY)、...目的分析1990—2019年我国出生窒息/创伤所致新生儿脑病的疾病负担水平及其变化趋势。方法从2019年全球疾病负担研究数据库中提取1990—2019年我国出生窒息/创伤所致新生儿脑病的伤残调整寿命年(disability-adjusted life years,DALY)、DALY率、死亡人数、死亡率、危险因素等数据。采用Joinpoint回归分析计算死亡率和DALY率的年度平均百分比变化(annual average percentage change,AAPC)以及95%置信区间(confidence interval,CI)。结果2019年我国出生窒息/创伤所致新生儿脑病死亡率为1139.527人/10万,DALY率为101275.239人年/10万,与1990年相比,均下降了76.23%。其中,男性和女性新生儿的死亡率分别为1230.738人/10万、1033.004人/10万,DALY率分别为109381.824人年/10万、91807.766人年/10万;0~6 d和7~28 d新生儿的死亡率分别为4022.626人/10万、178.166人/10万,DALY率分别为357481.444人年/10万、15844.063人年/10万。1990—2019年出生窒息/创伤所致新生儿脑病死亡率和DALY率的AAPC均为-4.88[95%CI(-5.17,-4.59)]。小于胎龄儿、早产、环境颗粒污染物和固体燃料燃烧的家庭污染是我国出生窒息/创伤所致新生儿脑病的主要危险因素。结论相较于1990年,2019年我国出生窒息/创伤所致新生儿脑病死亡率、DALY率均呈下降趋势,出生早期男性儿童的疾病负担高于女性儿童,因此应针对小于胎龄儿、早产、环境颗粒物污染、固体燃料燃烧的家庭污染等危险因素制定政策,继续重视孕期保健服务,以期进一步降低出生窒息/创伤所致新生儿脑病的疾病负担。展开更多
目的探讨出生顺序对双胎早产儿并发症的影响及其原因。方法选取2020年1月—2020年12月嘉兴市妇幼保健院新生儿科收治的胎龄<35周的双胎早产儿42对为研究对象,按照出生顺序分为先出生组和后出生组,配对分析比较组间基线资料、并发症...目的探讨出生顺序对双胎早产儿并发症的影响及其原因。方法选取2020年1月—2020年12月嘉兴市妇幼保健院新生儿科收治的胎龄<35周的双胎早产儿42对为研究对象,按照出生顺序分为先出生组和后出生组,配对分析比较组间基线资料、并发症发病率、呼吸支持治疗情况、Apgar评分及血清维生素水平。结果先后娩出的双胎早产儿间呼吸窘迫综合征(RDS)发病率(14.3%vs.40.0%,P<0.05)、呼吸衰竭发病率(2.4%vs.16.7%,P<0.05)、肺泡表面活性物质(PS)使用率(11.9%vs.28.6%,P<0.05)存在显著差异。后出生组的1 min、5 min及10 min Apgar评分低于先出生组,差异有统计学意义(P<0.05);而组间血清维生素A、D及E水平无显著差异。结论对胎龄<35周的双胎早产儿,后娩出者发生RDS、呼吸衰竭、使用PS的风险更高,其原因可能是与后娩出者更易窒息有关,而与新生儿本身血清维生素A、D及E水平无关。展开更多
【目的】分析出生指标,评价双胎妊娠结局。【方法】采用1995年苏州地区围产保健监测资料,比较单、双胎孕周、出生体重、Apgar评分、新生儿死亡率及死亡原因。【结果】双胎妊娠中早产儿占35.0%;低出生体重儿占4 9.2%;1 min和5 min Apgar...【目的】分析出生指标,评价双胎妊娠结局。【方法】采用1995年苏州地区围产保健监测资料,比较单、双胎孕周、出生体重、Apgar评分、新生儿死亡率及死亡原因。【结果】双胎妊娠中早产儿占35.0%;低出生体重儿占4 9.2%;1 min和5 min Apgar评分窒息者分别占1 3.9%和5.6%;各指标均显著高于单胎。双胎新生儿死亡率为45.9‰;早期新生儿死亡率42.8‰;新生儿主要死亡原因为早产。【结论】与单胎儿相比,双胎妊娠胎儿宫内发育时间、发育状况、产后适应能力等均明显偏差,新生儿死亡率显著偏高。应采用多种干预措施,改善双胎妊娠不良结局。展开更多
文摘<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> Birth Asphyxia (BA) is one of the leading causes of neonatal death in developing countries. In Togo, 30.55% of neonatal deaths were related to BA and caused by several risk factors. The purpose of this piece of work is to analyse the antepartum, intrapartum, and foetal risk factors of BA. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is a case control study, conducted from 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> December 2019 to 28</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> February 2020 in obstetrics wards and at neonatal intensive care of paediatric ward at the Sylvanus Olympio university teaching hospital (CHU-SO) in Lomé, Togo. Neonates diagnosed with BA (Apgar score < 7 at 5</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> minute) were considered as “cases” (N = 200) while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as “control” (N = 200). </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The prevalence rate of BA was 9.13%. Age (p = 0.0391), gravidity (p = 0.0040), type of facility for prenatal follow-up (p < </span></span><span style="font-family:Verdana;">0.0001), use of Long-lasting impregnated mosquito nets (LLIN) (p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), notion of maternal fever (p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001) </span><span style="font-family:Verdana;">and chronic pathology (p < </span><span style="font-family:Verdana;">0.0001) were related to occurrence of BA. Significant antepartum risk factors observed were age < 25 years (OR = 1.15;CI 95% [0.66 - 1.98], p = 0.0391), primigravidity (OR = 1.82;95% CI [0.86 - 3.85], 0.0040), prenatal follow-up in a</span><span style="font-family:Verdana;"> private one (OR = 1.62;CI95% [1.03 - 12.55], p < </span><span style="font-family:Verdana;">0.0001), non-use of LLIN (OR = 2.50;CI 95% [1.61 - 3.88], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), maternal fever (OR = 3.73;CI 95% [2.33 - 5.97], p < 0.0001) and existence of maternal chronic pathology (OR = 36.0, 95% [4.94 - 262.60], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0</span><span style="font-family:Verdana;">001). Significant intrapartum risk factors were PRM (OR = 7.89;CI 95% [2.62 - 14.02], p < </span><span style="font-family:Verdana;">0.0001), abnormal AF (OR = 5.40;CI 95% [2.57 - 11.38],], p </span><span style="font-family:Verdana;">< </span><span style="font-family:Verdana;">0.0001), long labour (OR = 2.11;CI 95% [1.34 - 3.34],], p = 0.0004), use of oxytocin (OR = 2.14;CI 95% [1.3</span><span style="font-family:Verdana;">8 - 3.32], p = 0.0003), and spontaneous vaginal (OR = 1.76;CI 95% [1.14 - 2.72,], p = 0.0008]). Significant Foetal risk factors were male gender (OR = 1.55;CI 95% [1.03 - 2.33], p = 0.0423), preterm babies (OR = 8.83;CI 95% [3.79 - 20.60], p < </span><span style="font-family:Verdana;">0.0001) and baby </span><span style="font-family:Verdana;">birth weight < 2500 gr (OR = 2.96;CI 95% [1.82 - 4.79], p < </span><span style="font-family:""><span style="font-family:Verdana;">0.0001). The Sarnat score had shown anoxo-ischemic encephalopathy stage III (19.00%), corresponding to 87.80% of case fatality rate (p < 0.0001). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Various risk factors lead to BA in Lomé. </span></span><span style="font-family:Verdana;">Early identification of high-risk cases with improved antenatal and perinatal care can decrease the high mortality of BA in Togo.</span>
文摘Objective:To evaluate the utilization of antenatal services by mothers of babies delivered with severe birth asphyxia at the University of Port Harcourt Teaching Hospital(UPTH) Port Harcourt,Nigeria.Methods: A case control study of the utilization of antenatal services by 97 mothers of newborns with severe birth asphyxia delivered at UPTH from 1st February to 31st October 2009 compared with mothers of newborns with normal Apgar scores was done.Relevant pregnancy,birth,family and social history was obtained by personal interviews and referral to case notes.Results: Significantly more of the mothers of babies with normal Apgar score booked early(4 months or less) and had up to 8 or more antenatal visits prior to delivery than mothers of asphyxiated babies 86(88.6%) vs 68(70.2%),P=0.002;93(95.7%) vs 68(70.2%),P=0.001 respectively.Significantly more subjects 56(57.7%) than the controls 45(46.4%) were primiparous,P= 0.04.Also,significantly more subjects 19(19.5%) suffered delay prior to intervention in labour than the controls 5(5.1%),P=0.004.Conclusion: Primiparity,delayed booking,inadequate antenatal visits and late intervention in labour have been identified as significant contributors to severe birth asphyxia.
文摘Background: Birth asphyxia is one of the major causes of neonatal deaths worldwide. Queen Elizabeth Central Hospital (QECH) neonatal ward records indicate that 36.5% of neonates admitted in the ward from April to September 2012 had birth asphyxia. This study was conducted to explore associative factors for birth asphyxia at QECH. Methodology: The study design was descriptive cross sectional that employed quantitative methods of data collection and analysis. Data sources were case notes of neonates and their mothers.? Sample size was 87 neonates with birth asphyxia and 87 neonates admitted with conditions other than birth asphyxia as controls. Data were collected from November to December 2013. Statistical Package for Social Science (SPSS) version16.0 was used to analyze data. Results: Findings revealed that there were no maternal associative factors for birth asphyxia, however, foetal distress, prolonged first and second stage of labour were significant associative factors for birth asphyxia. Conclusion: Associative factors for birth asphyxia at QECH are Foetal distress, prolonged first and second stage of labour. These factors can be prevented if quality care is provided to women in labour through close monitoring of foetal heart, appropriate use of the partograph, prompt decision making and early interventions.
文摘Background: During the past two decades there has been a sustained decline in child mortality;however, neonatal mortality has remained stagnant. Each year approximately 4 million babies are born asphyxiated resulting in 2 million neonatal deaths and intrapartum stillbirths. Almost all neonatal deaths occur in developing countries, where the majority is delivered at homes with negligible antenatal care and poor perinatal services. Objectives: To identify socio-demographic and clinical risk factors associated with birth asphyxia in Matiari District of Sindh Province, Pakistan. Method: A matched case control study was conducted in Matiari District with 246 cases and 492 controls. Newborn deaths with birth asphyxia diagnosed through verbal autopsy accreditation during 2005 and 2006 were taken as cases. Controls were the live births during the same period, matched on area of residence, gender and age. Result: The factors found to be associated with birth asphyxia mortality in Matiari District of Sindh Province, Pakistan are maternal education, history of stillbirths, pregnancy complications (including smelly or excessive vaginal discharge and anemia), intrapartum complications (including fever, prolong or difficult labour, breech delivery, cord around child’s neck, premature delivery, large baby size) and failure to establish spontaneous respiration after birth. Conclusion and Recommendation: There is an immediate need to develop strategies for early identification and management of factors associated with birth asphyxia by involving women, families, communities, community health workers, health professionals and policy makers. Community health workers should be trained for emergency obstetric care, basic newborn care including preliminary resuscitation measures to provide skilled birth attendance and encourage early recognition and referral.
文摘A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional using quantitative data analysis method on 75 midwives that were working in the maternity unit of the hospital. A structured questionnaire was used to collect data on participant’s demographic characteristics and midwives’ comprehension of birth asphyxia and an observational check list was used to observe midwives’ adherence to WHO resuscitation guidelines. In addition midwives were observed on their adherence to the Integrated Maternal and Neonatal Health guidelines that were developed by the Malawi Ministry of Health. The findings indicate that the midwives had knowledge of birth asphyxia in general. However, there were gaps in their ability to identify warning signs of birth asphyxia through partograph use. In addition the midwives did not adhere to 9 out of the 21 steps of the resuscitation guideline. Generally there was substandard adherence to guidelines on identification of warning signs of birth asphyxia and neonatal resuscitation. On the other hand, the facility did not have adequate resuscitation equipment and supplies. The results are discussed in relation to the importance of adhering to resuscitation guidelines in the management of birth asphyxia for babies that do not breathe at birth. Training of the midwives on partograph use and resuscitation to improve neonatal outcomes is recommended. It is recommended further that the health facility should have adequate resuscitation equipment and supplies.
文摘Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1st to June 30th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.
文摘目的探讨出生窒息早产儿纠正胎龄34周振幅整合脑电图(aEEG)评分差异及与Apgar评分、新生儿20项行为神经测定(NBNA)评分的相关性。方法回顾性选取2022年2月至8月在广州医科大学附属第二医院新生儿重症监护室(NICU)收治的早产儿,依据Apgar评分将其分为无窒息组、轻度窒息组以及重度窒息组。纠正胎龄34周时进行aEEG监测并运用Burdjalov评分系统评估脑发育成熟度。比较三组的aEEG各参数评分及总分;采用Spearman相关性分析探讨aEEG总分与Apgar评分以及纠正胎龄42周NBNA评分的相关性。结果重度窒息组的aEEG连续性、下边界振幅评分及总分均低于无窒息组(P<0.05);重度窒息组的下边界振幅评分低于轻度窒息组(P<0.05)。重度窒息组5 min Apgar评分与aEEG总分呈正相关(r=0.56,P=0.03)。重度窒息组纠正胎龄42周NBNA评分与aEEG总分呈正相关(r=0.91,P=0.01)。结论纠正胎龄34周的aEEG综合评分与重度窒息早产儿5 min Apgar评分有显著的相关性,aEEG综合评分可用于早期评估该类患儿的脑功能。
文摘Perinatal asphyxia is defined as harm to the fetus or the newborn caused by hypoxia and/or ischemia of various organs with intensity to produce biochemical and/or functional changes. Understanding the risk factors for this clinical condition allows the identification of vulnerable groups, enabling an improvement in care planning in the perinatal period in neonatal intensive care units. In this sense, this research aimed to identify risk factors for perinatal asphyxia present in newborns term that showed record for this clinical condition. This was a cross-sectional, retrospective documentary, quantitative and descriptive, conducted from data from medical records of 55 infants admitted to a neonatal intensive care unit. As for maternal characteristics (78.0%) had between 16 and 35 years, only one child (53.0%) and (76.0%) had no prior history of miscarriage. As for pre-existing diseases or pregnancy (38.0%) developed by Hypertensive Pregnancy Specific disease (02.0%) were suffering from Hypertension and (02.0%) of Diabetes Mellitus. As for newborns, most infants had birth weight (43.6%) and correlation with gestational age (78.2%) compatible for good conditions of birth. Only (20.0%) of the infants had a difficult labor. It stood out although there was a slight predominance of severe asphyxia (50.9%) in the first minute and (45.5%) of the infants had record release intrauterine meconium. It was concluded that most mothers and newborns did not have risk factors for perinatal asphyxia, thus, this fact could be attributed to the structural conditions of service, especially in the care during labor, delivery and immediate assistance newborn.
文摘目的分析1990—2019年我国出生窒息/创伤所致新生儿脑病的疾病负担水平及其变化趋势。方法从2019年全球疾病负担研究数据库中提取1990—2019年我国出生窒息/创伤所致新生儿脑病的伤残调整寿命年(disability-adjusted life years,DALY)、DALY率、死亡人数、死亡率、危险因素等数据。采用Joinpoint回归分析计算死亡率和DALY率的年度平均百分比变化(annual average percentage change,AAPC)以及95%置信区间(confidence interval,CI)。结果2019年我国出生窒息/创伤所致新生儿脑病死亡率为1139.527人/10万,DALY率为101275.239人年/10万,与1990年相比,均下降了76.23%。其中,男性和女性新生儿的死亡率分别为1230.738人/10万、1033.004人/10万,DALY率分别为109381.824人年/10万、91807.766人年/10万;0~6 d和7~28 d新生儿的死亡率分别为4022.626人/10万、178.166人/10万,DALY率分别为357481.444人年/10万、15844.063人年/10万。1990—2019年出生窒息/创伤所致新生儿脑病死亡率和DALY率的AAPC均为-4.88[95%CI(-5.17,-4.59)]。小于胎龄儿、早产、环境颗粒污染物和固体燃料燃烧的家庭污染是我国出生窒息/创伤所致新生儿脑病的主要危险因素。结论相较于1990年,2019年我国出生窒息/创伤所致新生儿脑病死亡率、DALY率均呈下降趋势,出生早期男性儿童的疾病负担高于女性儿童,因此应针对小于胎龄儿、早产、环境颗粒物污染、固体燃料燃烧的家庭污染等危险因素制定政策,继续重视孕期保健服务,以期进一步降低出生窒息/创伤所致新生儿脑病的疾病负担。
文摘目的探讨出生顺序对双胎早产儿并发症的影响及其原因。方法选取2020年1月—2020年12月嘉兴市妇幼保健院新生儿科收治的胎龄<35周的双胎早产儿42对为研究对象,按照出生顺序分为先出生组和后出生组,配对分析比较组间基线资料、并发症发病率、呼吸支持治疗情况、Apgar评分及血清维生素水平。结果先后娩出的双胎早产儿间呼吸窘迫综合征(RDS)发病率(14.3%vs.40.0%,P<0.05)、呼吸衰竭发病率(2.4%vs.16.7%,P<0.05)、肺泡表面活性物质(PS)使用率(11.9%vs.28.6%,P<0.05)存在显著差异。后出生组的1 min、5 min及10 min Apgar评分低于先出生组,差异有统计学意义(P<0.05);而组间血清维生素A、D及E水平无显著差异。结论对胎龄<35周的双胎早产儿,后娩出者发生RDS、呼吸衰竭、使用PS的风险更高,其原因可能是与后娩出者更易窒息有关,而与新生儿本身血清维生素A、D及E水平无关。
