Risk factors of birth asphyxia and subsequent newborn mortality in misurata central hospital, Libya

Background: Birth asphyxia is an important cause of neonatal morbidity and mortality worldwide, with approximately 4 million asphyxiated babies and 2 million neonatal deaths each year. Objectives: to identify antepartum, intrapartum, and fetal risk factors of birth asphyxia and their effect on neonatal survival. Methods: A cross-sectional study was conducted on 286 neonates with birth asphyxia in neonatal intensive care unit of Misurata Central Hospital, Libya. We retrospectively analyzed the hospital records from August 2015 to July 2016. Data include: babies’ and mothers' demographics; antepartum, intrapartum, and postpartum risk factors; APGAR scores; and neonatal survival. Results: Majority of cases are full-term (71%), of normal birth weight (68.9%) followed by pre-term (26.9%) of low birth weight (27.6%). Most cases are borne to mothers delivered by CS (59.4%), aged 20-25 years (32.9%), who were primi-gravid (59.4%) and (33.9%) of them reported irregular antenatal checkup. Non-survivor neonates represent (20.3%) with APGAR scores significantly lower than those of survivors. The most prevalent antepartum risk factors are maternal anemia, irregular antenatal visits and toxaemia of pregnancy (38.1%, 33.9% and 10.8% respectively) and intrapartum risk factors are meconium stained amniotic, prolonged labor, multiple pregnancy and malpresentation (16.4%, 13.3%, 11.2% and 11.2% respectively) with significant higher neonatal deaths among girls (93.1%), pre-term babies (46.6%) and babies with acidosis (22.4%). Conclusion: Majority of antepartum, intrapartum, and fetal risk factors studied were founded to play a role in birth asphyxia. Measures should be taken through means of good antenatal and perinatal care.