Introduction
Methods
Study area and period
Study design
Population
Sample size determination
Sampling procedure
Data collection tools and procedure
Operational definition
Cases
Outcome variable
Independent variable
Data quality control
Data processing and analysis
Results
Socio-demographic characteristics of the study participants
Variable | Cases (%) | Controls (%) | Total (%) |
---|---|---|---|
Age of the mother (year) | |||
< =19 | 8 (8.7) | 5 (2.7) | 13 (4.8) |
20–24 | 30 (32.6) | 38 (20.7) | 68 (24.6) |
25–29 | 28 (30.4) | 74 (40.3) | 102 (36.9) |
30–34 | 14 (15.2) | 33 (17.9) | 47 (17) |
> =35 | 12 (13.1) | 34 (18.5) | 46 (16.7) |
Residence | |||
Urban | 44 (47.8) | 106 (57.6) | 150 (54.3) |
Rural | 48 (52.2) | 78 (42.4) | 126 (45.7) |
Marital status | |||
Married | 74 (80.4) | 175 (95.1) | 249 (90.2) |
Single | 18 (19.6) | 9 (4.9) | 27 (9.8) |
Maternal education | |||
Can’t read and write | 39 (42.4) | 11 (6.0) | 50 (18.1) |
Primary school | 22 (23.9) | 27 (14.7) | 49 (17.8) |
Secondary school | 13 (14.1) | 71 (38.6) | 84 (30.4) |
College/university | 18 (19.6) | 75 (40.7) | 93 (33.7) |
Maternal occupation | |||
House wife | 45 (48.9) | 35 (19.0) | 80 (29.0) |
Merchant | 13 (14.1) | 16 (8.7) | 29 (10.5) |
Farmer | 8 (8.7) | 11 (6.0) | 19 (6.9) |
Private employee | 11 (12.0) | 69 (37.5) | 80 (29.0) |
Government employee | 15 (16.3) | 53 (28.8) | 68 (24.6) |
Ante partum related characteristics of the study participants
Variable | Cases (%) | Controls (%) | Total (%) |
---|---|---|---|
Parity | |||
1(premipara) | 46 (50.0) | 37 (20.1) | 83 (30.1) |
2–4(multipara) | 29 (31.5) | 129 (70.1) | 158 (57.2) |
> =5(grand multipara) | 17 (18.5) | 18 (9.8) | 35 (12.7) |
ANC follow up | |||
< = two | 39 (42.3) | 24 (13.0) | 63 (22.8) |
Three | 20 (21.7) | 19 (10.3) | 39 (14.1) |
Four and above | 33 (36.0) | 141 (76.7) | 174 (63.1) |
APH | |||
Yes | 25 (27.2) | 7 (3.8) | 32 (11.6) |
No | 67 (72.8) | 177 (96.2) | 244 (88,4) |
PIH | |||
Yes | 19 (20.7) | 7 (3.8) | 26 (9.4) |
No | 73 (79.3) | 177 (96.8) | 250 (90.6) |
Anemia | |||
Yes | 21 (22.8) | 6 (3.3) | 27 (9.8) |
No | 71 (77.2) | 178 (96.7) | 249 (90.2) |
Chronic disease | |||
Yes | 13 (14.1) | 14 (7.6) | 27 (9.8) |
No | 79 (85.9) | 170 (92.4) | 249 (90.2) |
Intra partum related characteristics of the study participants
Variable | Cases (%) | Controls (%) | Total (%) |
---|---|---|---|
Labor attendant | |||
Midwives | 39 (43.4) | 44 (23.9) | 83 (30.1) |
General practitioner | 30 (36.6) | 92 (50.0) | 122 (44.2) |
Gynecologist | 23 (25.0) | 48 (26.1) | 71 (25.7) |
Type of labor | |||
Spontaneous | 50 (54.3) | 156 (84.8) | 206 (74.6) |
Induced | 42 (45.7) | 28 (15.2) | 70 (25.4) |
Duration of labor | |||
Normal | 24 (20.1) | 151 (82.1) | 175 (63.4) |
Prolonged | 68 (79.9) | 33 (17.9) | 101 (36.6) |
Mode of delivery | |||
SVD | 37 (40.2) | 131 (71.2) | 168 (60.9) |
Instrumental | 26 (28.3) | 23 (12.5) | 49 (17.7) |
CS | 29 (31.5) | 30 (16.3) | 59 (21.4) |
Amniotic fluid | |||
Stained | 46 (50.0) | 14 (7.6) | 60 (21.7) |
Non stained | 46 (50.0) | 170 (92.4) | 216 (78.3) |
PROM | |||
Yes | 39 (42.4) | 25 (13.6) | 64 (23.2) |
No | 53 (57.6) | 159 (86.4) | 212 (76.8) |
Obstructed labor | |||
Yes | 27 (29.3) | 16 (8.7) | 43 (15.6) |
No | 65 (70.7) | 168 (91.3) | 233 (84.4) |
Fetal presentation | |||
Cephalic | 68 (73.9) | 162 (88.0) | 230 (83.3) |
Not cephalic | 24 (26.1) | 22 (12.0) | 46 (16.7) |
Cord prolapse | |||
Yes | 13 (14.1) | 2 (1.1) | 15 (5.4) |
No | 79 (85.9) | 182 (98.9) | 261 (94.6) |
Newborn related characteristics of the study participants
Variable | Cases (%) | Controls (%) | Total (%) |
---|---|---|---|
Sex of new born | |||
Male | 54 (58.7) | 107 (58.2) | 161 (58.3) |
Female | 38 (41.3) | 77 (41.8) | 115 (41.7) |
Gestational age | |||
Pre-term | 22 (23.9) | 6 (3.3) | 28 (10.1) |
Term | 38 (41.3) | 166 (90.2) | 204 (73.9) |
Post-term | 32 (34.8) | 12 (5.5) | 44 (16.0) |
Birth weight | |||
< 2500 g | 39 (42.4) | 34 (18.5) | 73 (26.4) |
> =2500 | 53 (57.6) | 150 (81.5) | 203 (73.6) |
Determinants of birth asphyxia among newborns
Variable | Asphyxia status | COR (95%CI) | AOR (95%CI) | |
---|---|---|---|---|
Cases (%) | Controls (%) | |||
Maternal education | ||||
Can’t read & write | 39 (42.4) | 11 (6.0) | 14.8 (6.4, 34.4) | 4.7 (1.2, 11.9)* |
Primary school | 22 (23.9) | 27 (14.6) | 3.4 (1.6, 7.3) | 0.5 (0.1, 2.2) |
Secondary school | 13 (14.1) | 71 (38.6) | 0.8 (0.4, 1.7) | 0.5 (0.4, 2.4) |
Diploma & above | 18 (19.6) | 75 (40.8) | 1.0 | 1.0 |
ANC follow up | ||||
< Two | 39 (42.4) | 24 (13.1) | 6.9 (3.7, 13.1) | 4.6 (1.1, 9.5)* |
Three | 20 (21.7) | 19 (10.3) | 4.5 (2.2, 9.4) | 2.4 (0.5, 11.4) |
Four and above | 33 (35.9) | 141 (76.6) | 1.0 | 1.0 |
APH | ||||
Yes | 25 (27.2) | 7 (3.8) | 9.4 (3.9, 22.8) | 7.7 (1.5, 18.5)* |
No | 67 (72.8) | 177 (96.2) | 1.0 | 1.0 |
Type of labor | ||||
Spontaneous | 50 (54.3) | 156 (84.8) | 1.0 | 1.0 |
Induced | 42 (45.7) | 28 (15.2) | 4.7 (1.1, 7.4) | 6.4 (0.7, 37.2) |
Duration of labor | ||||
Normal | 24 (26.1) | 151 (82.1) | 1.0 | 1.0 |
Prolonged | 68 (73.9) | 33 (13.9) | 13.0 (2.4, 18.1) | 13.5 (2.0, 19.4)* |
Amniotic fluid | ||||
Stained | 46 (50.0) | 14 (7.6) | 12.1 (6.2, 24.0) | 11.3 (2.7, 39.5)* |
Non stained | 46 (50.0) | 170 (92.4) | 1.0 | 1.0 |
PROM | ||||
Yes | 39 (42.4) | 25 (13.6) | 4.7 (2.6, 8.5) | 6.1 (0.7, 8.5) |
No | 53 (57.6) | 159 (86.4) | 1.0 | 1.0 |
Obstructed labor | ||||
Yes | 27 (29.3) | 16 (8.7) | 4.4 (2.2, 8.6) | 1.2 (0.1, 2.0) |
No | 65 (70.7) | 168 (91.3) | 1.0 | 1.0 |
Fetal presentation | ||||
Cephalic presentation | 68 (73.9) | 162 (88.0) | 1.0 | 1.0 |
Breech presentation | 24 (26.1) | 22 (12.0) | 2.6 (2.0, 7.3) | 4.5 (2.0, 8.4)* |
Gestational age | ||||
Pre-term (< 37) | 22 (23.9) | 6 (3.3) | 1.4 (1.2, 6.1) | 4.1 (1.8, 9.2)* |
Term (37–39) | 38 (41.3) | 166 (90.2) | 0.2 (0.1, 1.3) | 0.1 (0.01, 0.5) |
Post-term (> = 40) | 32 (34.8) | 12 (6.5) | 1.0 | 1.0 |
Birth weight | ||||
< 2500 g | 39 (42.4) | 34 (18.5) | 3.3 (1.9, 5.7) | 2.7 (0.9, 8.5) |
> =2500 | 53 (57.6) | 150 (81.5) | 1.0 | 1.0 |
Discussion
In this study, induced labor doesn’t show an association with birth asphyxia when compared to Spontaneous labor. This result was congruent with the study conducted in West Shewa Zone, central Ethiopia [22]. But it was inconsistent with the Meta-analysis study conducted in Ethiopia [29]. This difference may be due to the difference in the study setting at which both this study and the central Ethiopia study were conducted in a single institution. This induction of labor may cause hyper-stimulation of the uterine constriction that could cause fetal heart rate changes. When constrictions are too fast and strong, the placenta, which helps carry oxygen-rich blood to the baby, often cannot recharge with an adequate supply of this blood for the baby [30].
In this study, we have limitations that should be noted. The study was done in single health facility therefore; it is difficult to generalize for the whole country with this small sample. This study also subjected to recalling bias of mothers when they remembered their previous history. The study also have other limitation that variables in intrapartum events like umbilical cord status, uterine rupture, placental abruption, shoulder dystocia and major maternal haemorrhage, trauma, cardiorespiratory arrest or maternal seizures immediately preceding delivery were not addressed.