Akmal Laeeq Chishty, Muhammad Azhar Iqbal, Abid Anjum, Sajid Maqbool.
Risk factor analysis of Birth Asphyxia at the Children`s Hospital, Lahore.
Pak Paed J Jan ;26(2):47-53.

A prospective study was carried out on cases of birth asphyxia in the neonatal unit of the Children`s hospital, Lahore to find out the clinical spectrum of birth asphyxia and risk factors for adverse outcome in admitted cases. Two hundred and ninety five consecutive cases fulfilling the inclusion criteria were included from Ist Jan 2001. Male female ratio was 2.6:1, with mean admission weight 2.89 Kg and mean gestation of 39.18 weeks. A majority were born vaginally (84%) and through C-section (16%) and were all outborn (home = 44%, maternities = 33%, hospitals =23%). 75% cases came within 24 hours of birth. Clinical spectrum showed that CNS was involved in almost all cases, followed by metabolic disturbances (43%), involvement of CVS (31 %), GIT (31 %), Pulmonary system (30%). Infections were present in 28.5% and hyperbilirubinemia in 26.5% cases. Regarding outcome, 189 cases (64%) were discharged home in satisfactory condition and 100 cases (34%) died. At discharge, 41% surviving neonates showed persistently abnormal neurologic findings. Risk factors identified for mortality were encephalopathy stage III, apnea needing ventilatiory support. Clinical evidence of brain edema, acidosis (pH<7.1), hypotension, pulmonary aspiration syndrome and bleeding diathesis. Antenatal monitoring of high risk pregnancies, timely referral and resuscitation at the time of birth at all levels is mandatory to reduce increasing severity related to birth asphyxia reflected as multisystem involvement and higher mortality.

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