PROFILE OF ASPHYXIATED BABIES AT NEONATAL INTENSIVE CARE UNIT IN A TERTIARY CARE HOSPITAL IN NORTH EASTERN INDIA

BACKGROUND Birth asphyxia is one of the major causes of neonatal mortality as well as morbidity in India, but it studied that the causes which lead to asphyxia are usually preventable. Many metabolic as well as other sequential changes occurs in the body as a result of birth asphyxia which further lead to major long-term sequelae like cerebral palsy, mental retardation and seizure disorder. AIM To identify antepartum, intrapartum and postnatal risk factors for neonatal mortality due to birth asphyxia and to assess the clinico-biochemical status and outcome in the early neonatal period of babies who were asphyxiated at birth. DESIGN Cohort study. SETTING Neonatal Intensive Care Unit, Gauhati Medical College and Hospital. METHODS After clearance from the Hospital Ethical Committee, all severely asphyxiated babies at birth, admitted to neonatal unit from August 2009 to July 2010 were included in the study. A specially designed questionnaire was used to assess the role of maternal factors and neonatal presentation of birth asphyxia. Antenatal and intrapartum factors like maternal anaemia, Pregnancy Induced Hypertension (PIH), eclampsia, antenatal visits, Meconium Stained Amniotic Fluid (MSAF) were recorded. Asphyxiated babies were observed for stages of Hypoxic Ischaemic Encephalopathy (HIE), reflexes and any end organ involvement. Investigations were done for blood counts, electrolytes, USG, etc. RESULTS Among 150 babies, we found significant association between birth asphyxia and factors like poor antenatal check-up (48%), MSAF (38.7%), maternal anaemia (78%), PIH (20.7%), eclampsia (15.3%), prolonged labour (28%), ante partum foetal distress (14.7%); 24% cases were in HIE stage I, 32% in stage II and 44% in stage III. Multiorgan involvement seen with renal (9.3%), haematological (3.3%) abnormalities. During management 54.6% needed inotropes (54.6%) for circulatory support, 60% cases needed anticonvulsant and mortality rate was (48%). CONCLUSION There were lots of potentially preventable factors associated with birth asphyxia, which can be prevented if there is proper antenatal care including prevention of anaemia and pregnancy induced complications and proper management during early neonatal period.