Clinical Profile and Outcome of Newborn with Perinatal Asphyxia in a Tertiary Center

Abstract

Introduction:Perinatal asphyxia is a critical condition that contributes to neonatal morbidity, and mortality, particularly in low-resource settings. Long-term neurodevelopmental impairments and hypoxic-ischemic encephalopathy are associated with perinatal asphyxia. The purpose of this study was to assess the clinical profile and outcome of newborns with perinatal asphyxia.

 Methods: A hospital-based descriptive cross-sectional study design was conducted in the neonatal intensive care unit of KIST Medical College and Teaching Hospital. A total of 73 consecutive asphyxiated newborns with or without HIE and admitted to Neonatal Intensive Care Unit in KIST Medical College and Teaching Hospital from Jan 2017- Jan 2022 were selected. Data on maternal, perinatal, and neonatal factors were collected and analyzed to identify determinants and outcomes of perinatal asphyxia. Baseline characteristics of patients were evaluated using descriptive statistics. Categorical variables were expressed in frequency and percentage (%). Neonatal outcome and their association with hypoxic-ischemic staging were analyzed through a chi-square test.

Results: The Apgar score of the asphyxiated newborns at 1 minute of birth was less than six (56.1%), and at 5 minutes of birth, the Apgar score of the 37.8% newborns was more or equal to 6. The majority of the newborns (12.2%) had meconium-stained amniotic fluid while 6.1% of the mothers experienced premature rupture of membranes. Hypoxic-ischemic encephalopathy grade 1, 2, and 3 was diagnosed among 6.1%, 13.4%, and 12.2% of the newborns respectively. About 69.5% of the newborns had improved status. 

Conclusion: The challenge of perinatal asphyxia remains a major concern in neonatal care in Nepal. Quality of antenatal care should be enhanced to identify and manage risk factors associated with perinatal asphyxia.