Determinants of birth Asphyxia among newborns in Adama Hospital Medical College, Adama town, Oromia region, Ethiopia: A case control study

Abstract Background: Perinatal asphyxia is a common and serious global health problem. According to the World Health Organization, four million neonatal deaths occur each year due to birth asphyxia. Babies born in sub-Saharan Africa have a very high risk of birth asphyxia, which accounts for approximately 280,000 deaths per year. In Ethiopia, nearly 250,000 children die every year before reaching their fifth birthday; approximately one-fourth of these are newborns who die of birth asphyxia. Although asphyxia is a serious health problem, evidence on its determinants is scarce or not readily available in the country in general, and in the study area in particular. Therefore, this study aimed to identify the determinants of birth asphyxia in newborns. Methods: A retrospective case-control study was conducted involving a sample of 345 newborns born at Adama Hospital Medical College from November 1, 2017, to February 30, 2018. All newborns diagnosed with birth asphyxia (Apgar score < 7 at 1st minute) were considered "cases" while newborns with no asphyxia (Apgar score ≥ 7 at 1st minute) were considered "controls.” The sample size was determined using the Epi Info 7 Statcalc in the facility with assumptions of a 95% confidence interval, 80% power, and an odds ratio of 2.5. Ethical issues were secured by the ethical committee of the Adama Hospital Medical College. Primary data were collected using structured and interviewer-administered questions regarding possible risk factors from mothers and newborns. The collected data were checked for completeness, entered using Epi Info7, and exported to SPSS version 20 for analysis. Results: Of 345 newborns, 115 were cases and 230 were controls. The median maternal age in the case and control groups was 26 years, with IQR of 23–30 years and 23–29 years, respectively. Significant perinatal risk factors of birth asphyxia were rural residence (AOR: 2.34 95% CL 1.29-4.26), prolonged labour (AOR: 10.12 95% CL 5.36-19.11), prolonged rupture of membrane (AOR: 3.47 95% CL 1.52-7.92), instrumental delivery (AOR: 2.67 95% CL 1.15-6.16), delivery by emergency C/S (AOR: 3.9 95% CL 1.84-8.63), cephalopelvic disproportion (AOR: 5.90 95% CL 1.54-30.17), breech presentation (AOR:2.4 95% CL 1.01-5.74) Preterm delivery (AOR: 9.34, 95% CI: 2.20–39.70) and low birth weight (AOR: 2.69, 95% CI: 1.06–6.75) Conclusion: Most of the risk factors associated with birth asphyxia can be prevented. Therefore, early and accurate diagnosis and proper management can reduce the incidence of birth asphyxia.