TREATMENT OUTCOME AND ASSOCIATED FACTORS OF PERINATAL ASPHYXIA AMONG NEONATES HOSPITALIZED IN THE NEONATAL INTENSIVE CARE UNIT OF HIWOT FANA COMPREHENSIVE SPECIALIZED HOSPITAL, HARAR, ETHIOPIA

Abstract

Introduction: Birth asphyxia is defined as neonate’s failure to initiate and sustain breathing at birth. It can be caused by events in the antepartum or intraparum period. Globally 20-30% of neonates with hypoxic ischemic encephalopathy die while 33–50% of survivors have permanent neurodevelopmental abnormalities (cerebral palsy, mental retardation). Most of the deaths occur in low-resource countries such as Ethiopia. The burden in our setting is not studied previously. Objectives: To assess treatment outcome and its associated factors of perinatal asphyxia among neonates hospitalized in the Neonatal Intensive Care Unit of Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia January 1, 2018- December 31, 2023. Methods and materials: A facility-based cross-sectional study was conducted among asphyxiated neonates admitted to the Neonatal Intensive Care Unit of Hiwot Fana Specialized Comprehensive Hospital. A total of 335 neonates were included in the study. Data was collected using a data extraction tool from the medical records of the neonates admitted from January 2018 to December 2023. It was collected from January 10 to January 30, 2024. Data was entered in to Microsoft Excel sheet and exported to statistical package of social sciences version 29 for analysis. The binary logistic regression model was used to identify the association between dependent and independent variables using an adjusted odds ratio with a 95% confidence interval. Finally, the statistical significance was declared with a p-value of less than 0.05. Result: A total of 335 neonates with perinatal asphyxia were included in the study. Of the 335, 96 (28.7%) died with 95% CI (23.9-33.8%). In multivariable analysis, maternal obstetric complications (AOR= 2.64, 95%CI: 1.43-4.87), birth weight (AOR-2.13 95%CI 1.11-4.07), Stage II HIE (AOR=6.61 95%CI: 2.25-19.41) and stage III HIE (AOR= 84.56 95%CI 25.68- 278.44) were factors significantly associated with mortality. Conclusion: The magnitude of mortality among asphyxiated neonates in the study area was high. There was statistically significant correlation with maternal obstetric complications, birth weight, and stage of HIE. Therefore, special attention should be given to maternal obstetric complications