Survival and predictors of asphyxia among neonates admitted in neonatal intensive care units of public hospitals, Addis Ababa, Ethiopia, 2021.
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Date
2021-05
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Addis Abeba University
Abstract
Background: Perinatal Asphyxia is an injury that occurs during the perinatal period due to
lack of oxygen flow to the fetus or infant, which may lead to ischemia of the brain or other
organs. Gathering current evidence on recovery time and survival predictors of perinatal
asphyxia is crucial to fill scarcity of information.
Objective: To assess survival and predictors of asphyxia among neonates admitted in
Neonatal Intensive Care Units of public hospitals, Addis Ababa, Ethiopia, 2021.
Methods: Hospital-based retrospective cohort study was conducted in four selected public
hospitals of Addis Ababa, Ethiopia. Data were collected from February 15 to 15 March, 2021
by reviewing medical charts of asphyxiated neonates who were registered from January 1,
2016, to December 31, 2020. Epi data version 4.6 was used for data coding, entering and used
STATA version 16 statistical software for further analysis. Cox-proportional hazards
regression analysis with 95% confidence interval and P-value < 0.05 level of significance was
used to verify predictors of survival of Perinatal Asphyxia.
Result: In this study, out of 411(94.5%) participants, 305(74.2%) of them survived during the
entire cohort. Overall incidence density rate of survival was found to be 10 (95% CI: 0.080.11)
per 100 neonate-days of observation with an overall median recovery time of 8 days.
Neonates those who have low birth weight (AHR: 0.67, 95% CI: 0.47- 0.96), stage II HIE
(AHR: 0.70, 95% CI: 0.51 - 0.97), stage III HIE (AHR: 0.44, 95% CI: 0.27 - 0.71), occurrence
of seizure (AHR: 0.61, 95% CI: 0.38 - 0.97), thrombocytopenia (AHR: 0.44, 95% CI: 0.24 -
0.80) and not supplied calcium gluconate within first days of life after birth (AHR: 0.75, 95%
CI: 0.58 - 0.99) were independent predictors of time to recovery of asphyxiated neonates.
Conclusion: In this study, recovery time was prolonged in any stages of HIE compared to
Saranat’s staging of HIE. This implies early prevention, strict monitoring and taking
appropriate measures timely is mandatory before babies transferred into highest stage of HIE
for satisfactory outcomes and reduce mortality.
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Keywords
Perinatal asphyxia, Predictors, Survival status, Neonatal intensive care unit.