Hypoxic-ischaemic encephalopathy based on clinical signs and symptoms and associated factors among neonates, Southern Ethiopian public hospitals: a case-control study

Getnet Melaku; Getachew Mergia; Senait Belay Getahun; Selamawit Semagn; Zemedu Awoke; Robel Hussien Kabthymer; Mesfin Abebe

doi:10.1097/MS9.0000000000001459

Hypoxic-ischaemic encephalopathy based on clinical signs and symptoms and associated factors among neonates, Southern Ethiopian public hospitals: a case-control study

Ann Med Surg (Lond). 2023 Dec 2;86(1):35-41. doi: 10.1097/MS9.0000000000001459. eCollection 2024 Jan.

Authors

Getnet Melaku¹, Getachew Mergia², Senait Belay Getahun¹, Selamawit Semagn³, Zemedu Awoke⁴, Robel Hussien Kabthymer⁵, Mesfin Abebe¹

Affiliations

¹ Departments ofMidwifery.
² Obstetrics and Gynecology.
³ Reproductive Health.
⁴ Anesthesiology.
⁵ Human Nutrition, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.

Abstract

Background: Hypoxic-ischaemic encephalopathy (HIE) is a severe condition that results from reduced oxygen supply and blood flow to the brain, leading to brain injury and potential long-term neurodevelopmental impairments. This study aimed to identify the maternal and neonatal factors associated with hypoxic-ischaemic encephalopathy among Neonates.

Methods: The authors conducted a case-control study in 15 public hospitals with 515 neonates and mothers (175 cases and 340 controls). The authors used a questionnaire and clinical records created and managed by Kobo software to collect data. The authors diagnosed hypoxic-ischaemic encephalopathy (HIE) by clinical signs and symptoms. The authors used logistic regression to identify HIE factors.

Results: Hypoxic-ischaemic encephalopathy (HIE) was associated with maternal education, ultrasound checkup, gestational age, delivery mode, and labour duration. Illiterate mothers [adjusted odds ratio (AOR)= 1.913, 95% CI: 1.177, 3.109], no ultrasound checkup (AOR= 1.859, 95% CI: 1.073, 3.221), preterm (AOR= 4.467, 95% CI: 1.993, 10.012) or post-term birth (AOR= 2.903, 95% CI: 1.325, 2.903), caesarean section (AOR= 7.569, 95% CI: 4.169, 13.741), and prolonged labour (AOR= 3.591, 95% CI: 2.067, 6.238) increased the incidence of HIE.

Conclusion: This study reveals the factors for hypoxic-ischaemic encephalopathy among neonates in Ethiopia. The authors found that neonates born to illiterate women, those who experienced prolonged labour, those whose mothers did not have ultrasound checkups during pregnancy, those delivered by caesarean section, and those born preterm, or post-term were more likely to develop hypoxic-ischaemic encephalopathy. These findings indicate that enhancing maternal education and healthcare services during pregnancy and delivery may positively reduce hypoxic-ischaemic encephalopathy among neonates.

Keywords: APGAR score; clinical signs and symptoms; hypoxic-ischaemic encephalopathy; neonates.