Perinatal Asphyxia: Multivariate Analysis of Risk Factors
THRATHIP KOLA TAT, M.D.*, NIRUN VANPRAPAR, M.D.*, WIBOOLPHAN THITADILOK, M.D.**
Affiliation : * Department of Pediatrics, ** Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700. Thailand.
Perinatal asphyxia contributes greatly to neonatal mortality and morbidity. In developing
countries, the need for risk assessment in perinatal asphyxia is obvious because of the high birth
rate and limited perinatal resources.
Objective : To determine the incidence and risk factors of perinatal asphyxia in infants
who were delivered from mothers with high-risk conditions.
Study design : A prospective study over a 5-year period from 1993 to 1997 was performed
at a tertiary level, referral hospital.
Patients and Method : Nine hundred and sixty-one infants who were delivered from
878 high-risk mothers were recruited. All of the risk factors that might have contributed to asphyxia
were identified and recorded. Univariate and stepwise multiple logistic regression analysis was
performed to identify significant factors that might have contributed to asphyxia, the odds ratios
and 95 per cent confidence interval were computed.
Results : Abnormal fetal heart rate pattern, thick meconium stained amniotic fluid, and
premature delivery, were three common risk factors for asphyxia. The mean gestational age was
37.6±3.5 weeks, 10.5 per cent (101/961) were infants less than 33 weeks. The incidence of
asphyxia was 9.7 per cent and was highest (26.7%) in infants less than 1000 g. By univariate
analysis, significant relationships between perinatal factors and asphyxia were found among birth
weight, gestational age, premature and breech delivery but stepwise multiple logistic regression
analysis revealed that only birth weight was significantly associated with perinatal asphyxia.
Conclusion : In countries where resources are limited, a neonatal resuscitation team
should be available for very low birth weight infants, premature and breech deli very.
Keywords : Perinatal Asphyxia, Risk Factors, Neonatal Mortality and Morbidity
