Magnitude and associated factors of birth injury among admitted neonates in neonatal intensive care units of comprehensive specialized hospitals in Northwest Ethiopia, 2023

Abstract Background Birth injury is defined as structural or functional damage to the body of a neonate caused by a traumatic event during birth. Birth injuries are among the top ten causes of neonatal mortality in low-income countries. This problem remains a challenge in Ethiopia, affecting the achievement of the United Nation’s Sustainable Developmental Goal 3 by 2030. The aim of this study was to assess the prevalence and associated factors of birth injury among neonates admitted to neonatal intensive care units (NICUs) of comprehensive specialized hospitals in Northwest Ethiopia, 2023. Method An institution-based cross-sectional study of 515 neonates with their mothers was conducted in neonatal intensive care units (ICUs) of five comprehensive specialized hospitals in Northwest Ethiopia. After the samples were selected through a systematic random sampling method, the data were collected by BSc nurses. Simple logistic regression analysis was used to analyse the associations between each independent variable and birth injury, whereas multiple logistic regression analysis was used to control for potential confounders. Result The prevalence of birth injury was 18.57%, with a 95% confidence interval (CI) of 12.1–22.1%. Factors such as the presence of obstetric complications such as gestational HTN (adjusted odds ratio (AOR), 5.1, 95% CI [1.7–15.3]), gestational DM (AOR, 3.1, 95% CI [1.2–7.8]), nonvertex fetal presentation (AOR, 3, 95% CI [1.4–6.4]), prolonged ROM (AOR, 2.8, 95% CI [1.2–6.3]), meconium-stained amniotic fluid (AOR, 7.9, 95% CI [3.3–19]), emergency type of CS (AOR, 3.2, 95% CI [1.1–9.4]), vacuum aspiration (AOR, 3.6, 95% CI [1.1–12.2]), forceps delivery (AOR, 4.2, 95% CI [1.1–16.1]), and macrosomic baby (AOR, 4.0, 95% CI [1.3–11.9]) were associated with birth injury. Conclusion The prevalence of birth injury in CSH NICUs in Northwest Ethiopia was high. The presence of obstetric complications, nonvertex fetal presentation, prolonged ROM, MSAF, emergency CS, operative vaginal deliveries and macrocosmic babies were all associated with birth injury in the area.