TITLE:
Risk Factors for Birth Asphyxia in Togo: A Case-Control Study
AUTHORS:
Foli Agbeko, Ayoko Améyo Kétévi, Mawouto Fiawoo, Bouwereou Bi-Labna Tata, Kokouvi Evenyo Abalo, Elom Ounoo Takassi, Baguilane Douaguibe, Djatougbé Ayaovi Elie Akolly, Homba Daké Batalia, Rollin Arnaud Djomaleu, Rachel Bayahou Kérékou, Manani Hemou, Mazama Pakoudjare, Magnoulelen Nzonou, Essèboè Koffitsè Sewu, Sollim Talboussouma, Bayaki Saka, Deladem Komi Azoumah, Edem Koffi Djadou, Kokou Nadiedjoa Douti, Adama Dodji Gbadoe, Yawo Dzayissé Atakouma
KEYWORDS:
Birth Asphyxia, Neonate, Risk Factor, Togo
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.11 No.4,
December
22,
2021
ABSTRACT: Background: Birth Asphyxia (BA) is
one of the leading causes of neonatal death in developing countries. In Togo,
30.55% of neonatal deaths were related to BA and caused by several risk
factors. The purpose of this piece of work is to analyse the antepartum,
intrapartum, and foetal risk factors of BA. Methods: This is a case
control study, conducted from 1st December 2019 to 28th February 2020 in obstetrics wards and at neonatal intensive care of paediatric
ward at the Sylvanus Olympio university teaching hospital (CHU-SO) in Lomé,
Togo. Neonates diagnosed with BA (Apgar score th minute)
were considered as “cases” (N = 200) while neonates born either with normal
vaginal delivery or by cesarean section having no abnormality were considered
as “control” (N = 200). Results: The prevalence rate of BA was 9.13%.
Age (p = 0.0391), gravidity (p = 0.0040), type of facility for prenatal
follow-up (p 0.0001), use of Long-lasting impregnated mosquito nets (LLIN) (p 0.0001), notion of maternal fever (p 0.0001) and chronic pathology (p 0.0001)
were related to occurrence of BA. Significant antepartum risk factors observed
were age private one (OR = 1.62; CI95% [1.03 - 12.55],
p 0.0001), non-use of LLIN (OR = 2.50; CI 95% [1.61 - 3.88], p 0.0001), maternal fever (OR = 3.73; CI 95%
[2.33 - 5.97], p 0.0001). Significant intrapartum risk factors
were PRM (OR = 7.89; CI 95% [2.62 - 14.02], p 0.0001), abnormal AF (OR
= 5.40; CI 95% [2.57 - 11.38],], p 0.0001),
long labour (OR = 2.11; CI 95% [1.34 - 3.34],], p = 0.0004), use of oxytocin
(OR = 2.14; CI 95% [1.38 - 3.32], p = 0.0003),
and spontaneous vaginal (OR = 1.76; CI 95% [1.14 - 2.72,], p = 0.0008]).
Significant Foetal risk factors were male gender (OR = 1.55; CI 95% [1.03 - 2.33],
p = 0.0423), preterm babies (OR = 8.83; CI 95% [3.79 - 20.60], p 0.0001)
and baby birth weight 0.0001). The Sarnat score
had shown anoxo-ischemic encephalopathy stage III (19.00%), corresponding to 87.80%
of case fatality rate (p Conclusion: Various risk factors
lead to BA in Lomé. Early identification of
high-risk cases with improved antenatal and perinatal care can decrease the
high mortality of BA in Togo.