Prevalence, Complications, Outcomes and Associated Factors of Perinatal Asphyxia in a Neonatal Unit in Port Harcourt, Southern Nigeria

Background: Perinatal asphyxia remains a leading cause of neonatal morbidity and mortality in Nigeria. This study aimed to assess the prevalence, complications, outcomes and associated factors of perinatal asphyxia among newborns admitted to the Special Care Baby Unit of the Rivers State University Teaching Hospital (RSUTH) Nigeria. Method: This descriptive cross-sectional study was conducted from 5th January 2021 to 4th January 2024. A structured questionnaire was used to obtain neonatal/maternal sociodemographic, clinical features, complications and outcome data. Associations between perinatal asphyxia, neonatal and maternal characteristics and ensuing complications were assessed. Logistic regression analysis was used to identify predictors of severe perinatal asphyxia. Results: The prevalence of perinatal asphyxia was 12.5%. Of the 171 neonates with moderate/severe perinatal asphyxia, 103 (60.2%) were males, delivered at a mean gestational age of 37.09(3.43 weeks and 105 (61.4%) were admitted < 2 hours of life. The commonest pregnancy-related complications were prolonged labour 25 (19.8%) and prolonged rupture of membranes 22 (17.5%). Whereas the commonest clinical features of perinatal asphyxia were respiratory distress 135 (84.4%) and seizures 44 (27.5%), the significantly associated complications were neonatal jaundice (P=0.007), hypoxic ischaemic encephalopathy (P= <0.001) and acute kidney injury (P=0.036). Although 25 (14.6%) of them died, delivery at RSUTH, AOR 3.3 (CI:1.367-7.863) was the predictor significantly associated with severe perinatal asphyxia. Conclusion: The prevalence of perinatal asphyxia was comparable to other resource-constrained settings. However, mortality remains high. Improvement of obstetric care, strengthening prompt referrals from primary healthcare and initiation of immediate neonatal resuscitation should improve asphyxia-related outcomes.