Severe perinatal asphyxia: Incidence, risk factors and short-term outcome in a regional hospital in Oman

ABSTRACT

This study was aimed to document the incidence, risk factors and short-term outcome of severe perinatal asphyxia in a regional referral hospital in Oman. Of the 7487 babies delivered in our hospital during a 3-years period [1999-2001], 61 [8.2 per thousand] suffered severe perinatal asphyxia. Twentyone other severely asphyxiated babies, delivered elsewhere, were referred to us for care. The identified risk factors in all these 82 babies comprised mainly of complications of labour or delivery [in 53 babies, 66%], low birth weight [in 24 babies, 29%] and maternal disease [17 instances, 21%]. Some babies had multiple risk factors Eighteen [22%] of the babies died, 15 [18%] survived but with residual neurodeficit, while 49 [60%] survived apparently intact. Predictors of an adverse outcome included an Apgar score of zero at one minute, or less than 4 at 5 minutes, low birth weight, and cerebral oedema of haemorrhage. Infants of primiparous mothers also fared poorly. We conclude that perinatal asphyxia is still a significant problem in our practice area. Many of the risk factors are potentially preventable. But attainment of that goal requires sustained health education, continuing improvements in the health services, and a change in societal attitude, especially in terms of reproductive demands on women