FREQUENCY OF RISK FACTORS OF BIRTH ASPHYXIA IN NEONATES

Abstract

Birth asphyxia is a critical contributor to neonatal morbidity and mortality, particularly in low- and middle-income countries. Despite advances in perinatal care, limited data exist regarding its prevalence and associated risk factors in Pakistan. This study aimed to determine the prevalence of birth asphyxia and identify its associated obstetric and neonatal risk factors among newborns delivered at the Combined Military Hospital (CMH), Nowshera. A hospital-based cross-sectional study was conducted between 10^th January to 15^th June 2025 at the Department of Pediatrics, CMH Nowshera. A total of 101 neonates were selected using systematic sampling. Data was collected through structured questionnaires and medical record reviews. Bivariate and multivariate logistic regression analyses were performed to assess factors independently associated with birth asphyxia. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and statistical significance was set at p < 0.05. The prevalence of birth asphyxia was 19.8%. Factors significantly associated with increased odds of birth asphyxia included instrumental delivery (AOR=2.87; 95% CI: 1.09-7.55), primiparous mothers (AOR=2.04; 95% CI: 1.10-3.80), induction of labor (AOR = 3.59; 95% CI: 1.36–9.46), prolonged labor ≥24 hours (AOR=2.78; 95% CI: 1.32–5.80), meconium-stained amniotic fluid (AOR=3.49; 95% CI: 1.43-8.52), and referral from other facilities (AOR = 3.68; 95% CI: 1.46-9.28). The study revealed a notably high prevalence of birth asphyxia in the study population. Strengthening intrapartum monitoring, timely obstetric interventions, and optimizing referral systems are recommended to reduce the incidence of birth asphyxia in similar healthcare settings