Birth Asphyxia: A Major Cause of Early Neonatal Mortality in a Tanzanian Rural Hospital

Pediatrics, 05/11/2012

Ersdal HL et al. – Most cases of early neonatal mortality were related to birth asphyxia (BA), and prematurity and low birth weight (LBW) are additional important considerations. Reducing perinatal mortality requires a multifaceted approach with attention to issues related to BA, potential complications of prematurity, and LBW. The 5–minute Apgar score is a poor surrogate of BA.

Methods

  • This is a prospective descriptive observational study conducted in the delivery room and adjacent neonatal area.
  • Research assistants were trained to observe and record events related to labor, neonatal resuscitation, and 24-hour postnatal course.
  • BA was defined as failure to initiate spontaneous respirations and/or 5-minute Apgar score <7, prematurity as gestational age <36 weeks, and low birth weight (LBW) as birth weight <3rd centile for gestational age. Data were analyzed with X2 and Student’s t tests.

Results

  • Over 1 year, 4720 infants were born and evaluated. Of these, 256 were admitted to the neonatal area.
  • Forty-nine infants died secondary to BA (61%), prematurity (18%), LBW (8%), infection (2%), congenital abnormalities (8%), and unclear reason (2%).
  • The 5-minute Apgar score was >7 in 50% of the infants who died secondary to BA.

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