Study of clinical-etiological profile, outcome and maternal risk-factors of birth asphyxia: a hospital based observational study




Birth asphyxia, Neonatal mortality, HIE


Background: Birth asphyxia is an important cause of neonatal morbidity and mortality. According to world health organization (WHO) out of the 130 million babies born every year, about 4 million die in the first 4 weeks of life the neonatal period. This study is aimed to assess the incidence, risk factors, complications and maternal variables associated with birth asphyxia.

Methods: This is a prospective observational study conducted at pediatric newborn stabilization unit (NBSU) district hospital, Bageshwar (Uttarakhand) over a period of 12 months from January 2021 to December 2021. Total 110 newborns with no spontaneous breathing or APGAR score <7 at 5-minute requiring basic/advanced neonatal resuscitation as per NRP AHA protocol were enrolled in this study. Detailed mother’s antenatal history, risk factors along with clinical course of neonate was documented as per NICU protocol till the hospital stay in pre-designed pro-forma.

Results: Total 110 newborns were admitted with incidence of 6.2% and mean birth weight of 2760±575 gm. Male gender (71%), Term delivery (82.7%), majority 85.4% neonates were revived by basic, 27.2% developed HIE grade 1. Outcome wise majority 71% (78) were discharged, 22.7% (25). Among maternal variables, majority 82.7% (91) were booked pregnancy with mean maternal age 25.69-year, multigravida 54% (59), anemia 54.5% (60) and meconium-stained amniotic fluid (MSAF) constitutes most common risk factor.

Conclusions: Birth asphyxia is an important contributor of perinatal morbidity and mortality. Focus on early identification and timely management along with proper antenatal care and identification of high-risk pregnancy is crucial.


Author Biography

Mamta Nikhurpa, Department of Paediatrics, District Hospital Bageshwar, Uttarakhand, India

Consultant Pediatrician


Lawn JE, Blencowe H, Waiswa P. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387:587-603.

United Nations. The Millenium Development Goals Report. New York. 2010.

Vashishtha VM. The state of the world's children 2009: maternal health is the key to achieve MDGs 4 and 5. Indian Pediatr. 2009;46:233-4.

NNPD Network, Indian Council of Medical Research, National Neonatology Forum. 2005. Available at: Accessed on 12 June 2022.

WHO. Perinatal Mortality: A Listing of Available Information. Geneva: WHO; 1996.

Leuthner SR, Das UG. Low Apgar scores and the definition of birth asphyxia . Pediatr Clin North Am. 2004;51:737-45.

Cunningham FG, Bloom SL, Hauth JC, Rouse DJ, Spong CY et al. Williams obstetrics. 23. USA: McGraw-Hill. 2010.

Gleason C, Devaskar S, Avery M. Avery's diseases of the newborn. Philadelphia, PA: Else-vier/Saunders. 2012.

Chandra S, Ramji S, Thirupuram S. Perinatal asphyxia: multivariate analysis of risk factors in hospital births. Indian Pediatr. 1997;34:206-12.

WHO. World Health Statistics: Monitoring Health for Sustainable Development Goals (Sdgs). WHO Library Cataloguing-in-Publication Data, 2016. Available at: Accessed on 12 June 2022.

Wall SN, Lee AC, Niermeyer S. Neonatal resuscitation in low-resource settings: what, who, and how to overcome challenges to scale up? Int J Gynaecol Obstet. 2009;107(1):S47-64.

Ersdal HL, Mduma E, Svensen E, Perlman J. Birth asphyxia: a major cause of early neonatal mortality in a Tanzanian rural hospital. Pediatrics. 2012;129(5):e1238-43.

Little GA, Keenan WJ, Niermeyer S, Singhal N, Lawn JE. Neonatal nursing and helping babies breathe: an effective intervention to decrease global neonatal mortality. Newborn Infant Nurs Rev. 2011;11(2):82-7.

Babu BVA, Devi SS, Kumar BK. Birth asphyxia-incidence and immediate outcome in relation to risk factors and complications. Int J Res Health Sci. 2014;2(4):1064-71.

Dalal EA, Bodar NL. Astudy on birth asphyxia at tertiary health centre. Natl J Med Res. 2013;3:374-6.

Sunny AK, Paudel P, Tiwari J. A multicenter study of incidence, risk factors and outcomes of babies with birth asphyxia in Nepal. BMC Pediatr. 2021;21:394.

Yadav N, Damke S. Study of risk factors in children with birth asphyxia. Int J Contemp Pediatrics. 2017;4(2):518.

Mohan K, Mishra PC, Singh DK. Clinical profile of birth asphyxia in newborn. Int J Sci Tech. 2013;3(1):10-9.

Mamo SA, Teshome GS, Tesfaye T, Goshu AT. Perinatal asphyxia and associated factors among neonates admitted to a specialized public hospital in South Central Ethiopia: A retrospective cross-sectional study. PLoS ONE. 2022;17(1):e0262619.

Simchen MJ, Weisz B, Zilberberg E, Morag I, Weissmann-Brenner A, Sivan E et al. Male disadvantage for neonatal complications of term infants, especially in small-for-gestational age neonates. J Matern Fetal Neonatal Med. 2014;27:839-43.

Aibar L, Puertas A, Valverde M, Carrillo MP, Montoya F. Fetal sex and perinatal outcomes. J Perinat Med. 2012;40:271-6.

Pongou R. Why is infant mortality higher in boys than in girls? A new hypothesis based on preconception environment and evidence from a large sample of twins. Demography. 2013;50(2):421-44.

Aslam HM, Saleem S, Afzal R, Iqbal U, Saleem SM, Shaikh MW et al. Risk factors of birth asphyxia. Ital J Pediatr. 2014;40(1):94.

Dubie AG, Kokeb M, Mersha AT. Prevalence and associated factors of perinatal asphyxia in newborns admitted to neonatal intensive care unit at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, Ethiopia. BMC Pediatr. 2021;21:525.

Cunningham FG, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics. 23rd ed. USA: McGraw-Hill. 2010.

Berhe YZ, Kebedom AG, Gebregziabher L. Risk Factors of Birth Asphyxia Among Neonates Born in Public Hospitals of Tigray, Northern Ethiopia. Pediatric Health Med Ther. 2020;11:13-20.

Bahubali G, Vishnu BB, Rao R, Nandakumar S, Adhisivam B, Rojo J et al. Antenatal and intrapartum risk factors for perinatal asphyxia: A case control study. Curr Pediatr Res. 2013;17(2):119-22.

Solayman M, Hoque S, Akber T, Islam MI, Islam MA. Prevalence of Perinatal Asphyxia with Evaluation of Associated Risk Factors in a Rural Tertiary Level Hospital. KYAMC J. 2017;8:1.

Herting E, Rauprich P, Stichtenoth G, Walter G, Johansson J, Robertson B. Resistance of different surfactant preparations to inactivation by meconium. Pediatr Res. 2001;50:44-9.




How to Cite

Nikhurpa, M. (2022). Study of clinical-etiological profile, outcome and maternal risk-factors of birth asphyxia: a hospital based observational study. International Journal of Research in Medical Sciences, 10(10), 2167–2172.



Original Research Articles