Birth asphyxia and hypoxic-ischaemic encephalopathy: incidence and severity

Area of Science:

• Neonatal Health
• Perinatal Medicine
• Public Health

Background:

• Birth asphyxia poses a significant threat to newborns, particularly in resource-limited settings.
• Understanding incidence and risk factors is crucial for effective intervention strategies.

Purpose of the Study:

• To determine the incidence of clinically significant birth asphyxia in Nigerian infants.
• To identify associated risk factors, such as intrauterine growth retardation.
• To evaluate the Apgar score's correlation with hypoxic-ischaemic encephalopathy.

Main Methods:

• A 3-year observational study was conducted in a Nigerian tertiary referral hospital.
• Data collected included live birth rates, asphyxia incidence, and infant characteristics.
• Clinical presentation of hypoxic-ischaemic encephalopathy was compared with Apgar scores.

Main Results:

• The overall incidence of birth asphyxia was 26.5 per 1000 live births.
• Severely abnormal features (seizures, coma) were observed in 12.1/1000 live births.
• Infants with intrauterine growth retardation showed a significantly higher incidence (30.7%) of asphyxia compared to large-for-gestational-age infants (3%).
• The Apgar scoring system demonstrated poor correlation with clinical outcomes of hypoxic-ischaemic encephalopathy.

Conclusions:

• Birth asphyxia remains a critical issue in Nigeria, with a notable impact on growth-restricted infants.
• The Apgar score may not reliably predict the severity of birth asphyxia complications.
• Substantial improvements in healthcare delivery are necessary to reduce the incidence of birth asphyxia and its sequelae.