Background/Aims A preliminary survey at Machakos County Referral Hospital reported 430 cases of birth asphyxia in 2018, most of which were related to intrapartum events. The aim of this study was to determine intrapartum determinants of birth asphyxia at the hospital. Methods This descriptive cross-sectional study was conducted with 248 systematically sampled women from the labour and postnatal wards at the hospital. A structured observation checklist was used to provide data about labour progression while women were in active labour. Postnatally, participants were asked to complete a structured questionnaire about their perceptions of care offered during labour. Chi-squared tests were used to assess the relationship between intrapartum factors and birth outcomes. Logistic regression was used to establish intrapartum risk factors for birth asphyxia. Results Of the 248 births, 25.0% resulted in birth asphyxia. Maternal factors associated with birth asphyxia were gestational age ( P <0.0001), prolonged labour ( P =0.0003), birth complications ( P =0.0062) and pre-existing medical conditions ( P =0.0341). Associated fetal factors were presentation ( P =0.0001), meconium-stained amniotic fluid ( P <0.0001), weight at birth ( P =0.0041) and resuscitation ( P =0.0001). Associated health facility factors were labour augmentation ( P =0.0011) and a lack of standard operating procedures ( P =0.0061). The majority of participants reported that they would give birth again at the hospital in future (95.3%) and did not have doubts about the abilities of the midwives in the labour ward (99.2%). Conclusions Several significant determinants of birth asphyxia were found at the hospital, across maternal, fetal and health facility factors. The County Government of Machakos should ensure that midwives are trained on factors that contribute to birth asphyxia and implement guidelines to ensure early identification and intervention where necessary. Implications for practice Midwives need regular training on obstetric care and standard operating procedures should be implemented to prevent birth asphyxia. Healthcare professionals working in labour and birth wards should be aware of the risks of complicated labour and take early action to prevent birth asphyxia.
David et al. (Fri,) studied this question.