The prevalence, consequences, and outcome of perinatal asphyxia in term and late preterm live-born neonatesA A case-control study from Iran
1 Maternal, Fetal and neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
2 Department of Neonatology, Vali-E-asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
3 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
4 Pediatrics Department, School of Medicine, Ziaean Hospital, Tehran University of Medical Science, Tehran, Iran.
5 Department of Neonatology, Yas Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Research Article
World Journal of Advanced Research and Reviews, 2024, 22(01), 1476–1483
Publication history:
Received on 02 March 2024; revised on 17 April 2024; accepted on 20 April 2024
Abstract:
Background: Despite several investigations reporting the prevalence of asphyxia in developed and developing countries, very few studies from Iran have demonstrated the rate of neonatal asphyxia and its affecting factors. Objectives: This study aimed to determine the prevalence of asphyxia, its consequences, and neonatal outcomes among Iranian term and late preterm live-born neonates.
Methods: A case-control study was conducted in three hospitals; Vali-e-Asr, Yas, and Ziaean from April 2019 to March 2020. The case group included neonates with a history of perinatal asphyxia. Twice gestational age-matched subjects without such a history also entered the study as the control group. All maternal and neonatal data were collected from participants’ medical records. Determining the prevalence of neonatal asphyxia was the primary outcome of the present study.
Results: Totally 48 subjects as the case and control groups were included and 16 asphyxiated cases were observed equal to 3.3 per 1000 live-born neonates. Concerning the type of delivery, cesarean section in the control group and vaginal delivery in the case group were the most frequent types of delivery (p=0.041). Comparing neonatal variables, the results showed a significant difference regarding the groups’ genders (p=0.036). Apgar scores in the case group were also significantly lower than the control group (p=0.0001). More cases also required PPV compared to the controls (12 vs. 0; p=0.0001). Hypoxic-ischemic encephalopathy (HIE) grade 1 was also significantly more frequent in the case group than the controls (p=0.0001). The means of pH and base excess in the case group were significantly lower than the control group (p=0.0001).
Conclusion: The results showed the prevalence rate of asphyxia among term and late preterm participants was 3.3 cases per 1000 live-born neonates. Apgar scores<5 accompanied with metabolic acidosis, HIE, and requirement of PPV could be predictive variables for perinatal asphyxia. Observing such clinical risk factors may indicate the need of early diagnosis and timely interventions to improve neonatal outcomes.
Keywords:
Asphyxia; Hypoxic ischemic encephalopathy; Neonatal death; Apgar score
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