Determinants of Birth Asphyxia Among Newborns at a Tertiary Care Hospital, Central Ethiopia: A Case-Control Study

Birth asphyxia is a major cause of newborn deaths worldwide, especially in developing countries where access to skilled delivery care is limited. It is a significant health challenge in Ethiopia, contributing to many newborn deaths and long-term health issues. Despite efforts to improve maternal and newborn care, it remains a serious concern. Thus, this study was aimed at identifying the determinants of birth asphyxia among newborns at a tertiary care hospital in Central Ethiopia.

An institution-based unmatched case-control study was conducted among 345 participants with a case-to-control ratio of 1:2. Data were collected using a pretested, structured, interviewer-administered questionnaire and a data abstraction checklist. The collected data were entered into Epi Info Version 7.2 and analyzed using SPSS Version 27. Binary logistic regression analysis was performed to identify the determinants of birth asphyxia. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were used to estimate the strength of associations. Statistical significance was set at a p value < 0.05.

In this study, the place of residence (rural) (AOR = 2.34; 95% CI: 1.29-4.26), premature rupture of membrane (AOR = 3.47; 95% CI: 1.52-7.92), prolonged labor (AOR = 10.12; 95% CI: 5.36-19.11), noncephalic fetal presentation (AOR = 2.40; 95% CI: 1.01-5.74), instrumental delivery (AOR = 2.67; 95% CI: 1.15-6.16), and cesarean section delivery (AOR = 3.99; 95% CI: 1.84-8.63) were identified as independent determinants of birth asphyxia.

Rural residence, premature rupture of membranes, prolonged labor, noncephalic fetal presentation, instrumental delivery, and cesarean section delivery were determinants of birth asphyxia. Efforts to reduce birth asphyxia should focus on improving maternal healthcare in rural areas, enhancing the management of labor complications, and ensuring skilled delivery care, especially for noncephalic presentations and operative deliveries.