1MSc of Nursing, Bentolhoda Hospital, North Khorasan University of Medical Sciences, Bojnurd, Iran
2Assistant Professor of Neonatology, Department of Pediatrics, North Khorasan University of Medical Sciences, Bojnurd, Iran
3Resident of Pediatric Neurology, Department of Pediatric Neurology, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
4Assistant Professor of Orthodontics, Department of Orthodontics, North Khorasan University of Medical Sciences, Bojnurd, Iran
Background: Perinatal asphyxia is a common cause of infant morbidity and mortality and long-term neurological disabilities. Due to the high costs of admission, a large proportion of births and neonatal deaths occur in non-hospital settings. This study aimed to evaluate the incidence rate of perinatal asphyxia before and after the implementation of the health improvement program. Methods: This descriptive-analytical study was conducted on all the infants with moderate and severe asphyxia during April 2013-2015. Subjects were divided into two groups of A and B (born after and before the health improvement program, respectively). Maternal and neonatal data were recorded in checklists and compared between these groups. Data analysis was performed in SPSS version 17. Results: In total, 111 asphyxiated neonates were classified into two groups of A and B, and incidence rate of asphyxia was estimated at 0.54% and 1.05%, respectively. Severe asphyxia was observed in 35.7% and 28.9% of the infants in groups A and B, respectively. Moreover, mean duration of mechanical ventilation was 25 and 79 hours in groups A and B, respectively. Conclusion: According to the results of this study, implementation of the health improvement program reduced the incidence of perinatal asphyxia. In addition, number of cesarean cases due to previous C-section was observed to decrease. Therefore, it could be concluded that high-quality resuscitation efforts and restricted rules in the health improvement program lower the risk of long-term complications in asphyxiated neonates. However, no significant difference was observed in the mortality rate of the asphyxiated newborns in this study.
1- Chiesa C, Pellegrini G, Panero A, De Luca T, Assumma M, Signore F, et al. Umbilical cord interleakin-6 levels are elevated in term neonates with perinatal asphyxia. Eur J Clin Invest. 2003; 33(4):352-8.
2- Boskabadi H, Maamouri G, TavakolAfshari J, Taghi Shakeri M. Association between serum interleukin-1β levels and perinatal asphyxia. Iran J Neonatol. 2010; 1(1):24-9.
3- Low JA. Intrapartum fetal asphyxia: definition, diagnosis, and classification. Am J Obstet Gynecol. 1997; 176(5):957-9.
4- Dilenge ME, Majnemer A, Shevell MI. Long-term developmental outcome of asphyxiated term neonates. J Child Neurol. 2001; 16(11):781-92.
5- Perinatal morbidity. Report of the health care committee expert panel on perinatal morbidity. National Health and Medical Research Council. Australia: Australian Government Publishing Service; 1995.
6- Lown J, Shibuya K, Stein C. No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths. Bull World Health Organ. 2005; 83(6):409-17.
7- Badawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O'Sullivan F, Burton PR, et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case-control study. BMJ. 1998; 317(7172):1554-8.
8- Azra Haider B, Bhutta ZA. Birth asphyxia in developing countries: current status and public health implications. Curr Probl Pediatr Adolesc Health Care. 2006; 36(5):178-88.
9- Costello A, Francis V, Byrne A, Puddephatt C. The state or the worlds newborn: A report from saving newborn lives. Washington DC: Department of Public Affairs and Communications; 2001. P. 1-44.
11- Ellis M, de L Costello AM. Antepartum risk factors for newborn encephalopathy. Intrapartum risk factors are important in developing world. BMJ. 1999; 318(7195):1414.
12- Moss W, Darmstadt GL, Marsh DR, Black RE, Santosham M. Research priorities for the reduction of perinatal and neonatal morbidity and mortality in developing country communities. J Perinatol. 2002; 22(6):484-95.
13-Liston FA, Allen VM, O'Connell CM, Jangaard KA. Neonatal outcomes with caesarean delivery at term. Arch Dis Child Fetal Neonatal Ed. 2008; 93(3):F176-82.