Prevalence and risk factors associated with birth asphyxia: a systematic review and meta-analysis

ABSTRACT

Background. Birth asphyxia continues to be a key health issue in the world especially in the low-/middle-income countries since resources are constrained to manage the problem effectively.

Objective. To determine the prevalence of birth asphyxia and maternal, fetal, and intrapartum risks of the condition.

Methods. This systematic review and meta-analysis synthesized data from 52 studies involving nearly 59,000 neonates to determine the prevalence and key risk factors associated with birth asphyxia.

Results. The pooled prevalence rate was about 19.37 and there was a high level of heterogeneity among the regions, settings and study designs. The resource limited environments like Ethiopia and Sudan were found to have higher prevalence rates. Maternal factors (eclampsia, anemia, infections), fetal factors (prematurity, low birth weight, fetal distress), and intrapartum complications (prolonged labor, meconium-stained amniotic fluid, cord prolapse) are identified as the risk factors.

Conclusions. Birth asphyxia remains a major cause of neonatal morbidity and mortality. The extensive variation in prevalence rates underscores the role of varying clinical practices and standards of reporting. Enhancing antenatal and intrapartum services and capacity to provide neonatal resuscitation and enhancing regularity of diagnostic criteria can help decrease the incidence of birth asphyxia, especially in low-resource communities.

Key words

Birth asphyxia; neonatal morbidity; neonatal mortality; risk factors; prevalence.