PubMed · 10487115
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F G Becker-Christensen. 1999-08-02. [Neonatal asphyxia].. https://pubmed.ncbi.nlm.nih.gov/10487115/
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Babies of booked women who delivered in unorthodox health facilities in Calabar, Nigeria were studied. The aims were to determine the relative risk of birth asphyxia in these babies and to find out the management of birth asphyxia in these unorthodox delivery centres. The incidence (14.3%) of birth asphyxia in the study population was significantly higher than the incidence (4.8%) in babies of booked women who delivered in the University of Calabar Teaching Hospital (P < 0.001) with a relative risk of 3.0 (95% C.I.=1.74-5.19). Apart from prolonged labour, the predisposing factors to birth asphyxia in both the study group and control did not show any significant difference (P > 0.05). The treatment of birth asphyxia in unorthodox delivery centres consisted mainly of prayers (43.8%) and immersion of the asphyxiated baby in cold water (25%). A birth asphyxia case fatality rate of 20.8% was recorded in these unorthodox delivery facilities but no death in the control population. Appropriately directed antenatal health education on the benefit of delivering under supervision of trained personnel is strongly advocated.
In about 10 per cent of children with cerebral palsy, the most probable cause is birth asphyxia. The brain injury following birth asphyxia evolves in part over hours or days--as a secondary process. This opens a 'window of opportunity' for intervention. Decreasing the temperature by as little as 3 degrees C appears to be effective. It is possible to identify babies with a 50 per cent risk of death or survival with cerebral palsy within 3 to 6 hours after birth. Pilot trials of cooling suggest that the side-effects of cooling can be managed. Randomized controlled trials are underway. Obtaining informed consent from the parents for these trials represents a particular challenge.
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