Determinants of Birth Asphyxia at Public Hospitals in East wollega Zone, Ethiopia: a case control study

Abstract

Despite birth asphyxia is one of the most important causes of morbidity and mortality in new-borns; the determinants of birth asphyxia were no investigated according to the local context, especially in this a particular area. Therefore, this study aimed to identify the determinants in order to prevent the problem. Objectives: To identify determinants of birth asphyxia at public Hospital in East Wollega Zone, Oromia Region, West Ethiopia, 2019 Methods: A case-control study was conducted from March 10 to April 15,2019. Systematic random sampling technique was used to select 308 (103 cases and 205 controls) newborn. Data were collected using checklist for record review and interviewer administered questionnaire. The data were entered in to Epi-data version 3.1 and analysed using SPSS version 24. Variables with P-value <0.25 were taken to multi-variable regression. Backward likelihood ratio with 0.1 probability removal was used to develop the model. Collinearity, goodness fit of final model using Hosmer Lemeshow test considering good fit at P-value ≥ 0.05 (0.208), omnibus likelihood test <0.05(0.000) and model classification of accuracy (77.9%) were checked. Odds Ratio estimated with 95% CI was used to show strength of association and P-value < 0.05 was used to declare statistical significance. Result: A total of 308(103 cases and 205 controls) mothers of newborns were interviewed and record reviewed with response rate of 98%. Maternal factors like: being not educated (nonformal education) (AOR=2.44; [95%CI:1.37,4.34]), having antenatal care follow up <4 (AOR=2.30; [95% CI:1.17,4.53]), Prolonged duration of labour (AOR=4.12; [95% CI:1.78,9.50]), non-cephalic fetal presentation (AOR=4.35; [95%CI:1.77,10.67]) and being primi-parous (AOR=2.14; [95%CI:1.20,3.83]) were the predictors birth asphyxia. The neonatal factor such as: being preterm (AOR=5.77; [l95%:2.62,12.69]) and low birth weight (AOR=4.43; [95%:1.94,10.13]) were also the predictors of birth asphyxia. Conclusion: non-formal education, having less antenatal care follow up, prolonged duration of labor, being non-cephalic presentation, prim parous, preterm and low birth weight were the independent predictors of birth asphyxia. Interventions focusing in this area should give priority for these identified determinants.