Prevalence and factors associated with birth asphyxia among neonates born in Mubende regional referral hospital, Mubende district, Central Uganda.  A cross-sectional study.: A Cross-sectional Study

Isaac Newton   Ecaat Olupot

doi:10.51168/sjhrafrica.v7i3.2501

Authors

Isaac Newton Ecaat Olupot Mildmay Institute of Health Sciences

DOI:

https://doi.org/10.51168/sjhrafrica.v7i3.2501

Keywords:

Birth Asphyxia, Neonatal, Maternal, Risk Factors, Child birth

Abstract

Introduction

Birth asphyxia is a significant cause of neonatal mortality and lifelong morbidity worldwide. In Uganda, 28.6% of neonatal and 48% of perinatal deaths are due to birth asphyxia. Uganda recorded an average of 30 cases of asphyxia; the highest prevalence of 60 cases per 1000 live births being identified in Bundibugyo, Iganga and Mubende. There is scarcity of health facility-based data explaining this trend. This study aimed at determining the prevalence and factors associated with birth asphyxia among neonates born in Mubende regional referral hospital in Mubende district, central Uganda.

Methods

A quantitative cross sectional study design was used. Sample size of 97 was determined using Kish and Leslie formula (1965). 97 Mother-baby pairs were sampled consecutively. Paper based interviewer administered questionnaires were used to collect data. Data was entered into EpiData and exported to STATA 14 for analysis.

Results

96 mother-baby pairs were included in the final analysis. Prevalence of asphyxia was 4.17%. Of the 4 asphyxiated neonates, all (100%) were of male sex, born to mothers who were; of rural residence, referred to Mubende RRH in labour and had attained only primary level of education or less, while 3 (75%) had meconium-stained liquor. However, maternal education was the only factor association with birth asphyxia, higher education being protective against asphyxia (AOR 0.0606, P=0.0265, 95%CI 0.0008874 - 0.8189651)

Conclusion

The prevalence of birth asphyxia was high in our study indicating that 42 in every 1000 babies born in Mubende RRH are at a risk of birth asphyxia. Male neonates, rural residence, referral status, meconium staining, lower level of education contributed to birth asphyxia.

Recommendation

There is need to strengthen referral systems and prioritize mothers with male fetuses and lower education backgrounds to minimize asphyxia related mortality and morbidity.

Author Biography

Isaac Newton Ecaat Olupot, Mildmay Institute of Health Sciences

Public Health Officer and a Medical Clinical Officer.

Medical Clinical Officer and tutor at Mildmay institute of health Sciences

The author holds a BSN degree from Makerere University

References

Abate, B. J., Melesse, A. W., Brhan, H., & Agimas, M. C. (2025). Spatial variation, pooled prevalence, and factors associated with perinatal mortality in Sub-Saharan Africa, evidence from demographic and health surveys 2015–2023: A geospatial regression approach. eClinicalMedicine, 81, 103137. https://doi.org/10.1016/j.eclinm.2025.103137

Abebe, M., Tebeje, T. M., Gugsa, T., Kebede, D., Temesgen, T., Figa, Z., Melaku, G., Andargie, M., Solomon, Z., & Hareru, H. E. (2024). Factors associated with low fifth minute Apgar score among newborns delivered at public health facilities of Dilla town, Southern Ethiopia, 2022. International Journal of Africa Nursing Sciences, 20, 100656. https://doi.org/10.1016/j.ijans.2024.100656

Alfaifi, J., Ahmed, M. A., Almutairi, G. S., Alhumaidi, N. H., AlHabardi, N., & Adam, I. (2025). Prevalence of perinatal asphyxia and its associated factors among live birth in Khartoum, Sudan: A hospital-based cross-sectional study. BMC Pediatrics, 25(1), 150. https://doi.org/10.1186/s12887-025-05499-7

Ayebare, E., Hanson, C., Nankunda, J., Hjelmstedt, A., Nantanda, R., Jonas, W., Tumwine, J. K., & Ndeezi, G. (2022). Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: A cross-sectional study. BMC Pregnancy and Childbirth, 22(1), 767. https://doi.org/10.1186/s12884-022-05095-y

Bayih, W. A., Birhane, B. M., Belay, D. M., Ayalew, M. Y., Yitbarek, G. Y., Workie, H. M., Abie Tassew, D. M., Kebede, S. D., Alemu, A. Y., Gedefaw, G., Demis, A., & Chanie, E. S. (2021). The state of birth asphyxia in Ethiopia: An umbrella review of systematic review and meta-analysis reports, 2020. Heliyon, 7(10), e08128. https://doi.org/10.1016/j.heliyon.2021.e08128

Bayih, W. A., Yitbarek, G. Y., Aynalem, Y. A., Abate, B. B., Tesfaw, A., Ayalew, M. Y., Belay, D. M., Hailemeskel, H. S., & Alemu, A. Y. (2020). Prevalence and associated factors of birth asphyxia among live births at Debre Tabor General Hospital, North Central Ethiopia. BMC Pregnancy and Childbirth, 20, 653. https://doi.org/10.1186/s12884-020-03348-2

Desalew, A., Semahgn, A., & Tesfaye, G. (2020). Determinants of birth asphyxia among newborns in Ethiopia: A systematic review and meta-analysis. International Journal of Health Sciences, 14(1), 35–47. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012503/

Fitriana, Y., M, A. I., Mallongi, A., Mappajanci, M., Seweng, A., Hidayanty, H., Nur, R., & Syam, A. (2021). Risk factors for asphyxia neonatorum in public health centres of nosarara and pantoloan, Palu City. Gaceta Sanitaria, 35, S131–S134. https://doi.org/10.1016/j.gaceta.2021.07.009

Gillam-Krakauer, M., Shah, M., & Gowen Jr, C. W. (2025). Birth Asphyxia. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK430782/

Gizachew, S., Girma, W., Mekasha, G., & Arega abebe, L. (2024). Magnitude of neonatal asphyxia and its predictors among newborns at public hospitals of Wolaita Zone in Southern Ethiopia, 2023 | BMC Pediatrics | Full Text. https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-04627-z

Handing, G., Straneo, M., Agossou, C., Wanduru, P., Kandeya, B., Abeid, M. S., Annerstedt, K. S., & Hanson, C. (2024). Birth asphyxia and its association with grand multiparity and referral among hospital births: A prospective cross-sectional study in Benin, Malawi, Tanzania and Uganda. Acta Obstetricia et Gynecologica Scandinavica, 103(3), 590–601. https://doi.org/10.1111/aogs.14754

Ikang, B. U. (2018). Prevalence and factors associated with perinatal asphyxia among neonates hospitalized in the neonatal intensive care unit of Fort Portal regional referral hospital. http://hdl.handle.net/20.500.12306/4345

Jimma, M. S., Abitew, K. M., Chanie, E. S., GebreEyesus, F. A., & Kelkay, M. M. (2022). Determinants of birth asphyxia among newborns in Northwest Ethiopia, 2019: Case control study. Heliyon, 8(2), e08875. https://doi.org/10.1016/j.heliyon.2022.e08875

Kibai, E. K. (2017). PERINATAL FACTORS ASSOCIATED WITH BIRTH ASPHYXIA AMONG NEONATES IN MATERNITY WARD KAKAMEGA COUNTY REFFERAL HOSPITAL, KENYA. http://ir-library.mmust.ac.ke:8080/xmlui/handle/123456789/244

Komakech, A., Aceng, F. L., Migamba, S. M., Nakamya, P., Mutumba, R., Bulage, L., Kwesiga, B., & Ario, A. R. (2023). Trends and distribution of birth asphyxia, Uganda, 2017-2020: A retrospective analysis of public health surveillance data. https://doi.org/10.1101/2023.01.09.23284352

Milic, C. (2020, November 20). Improving resuscitation of asphyxiated babies at birth in Uganda. Clinton Health Access Initiative. https://www.clintonhealthaccess.org/blog/improving-resuscitation-of-asphyxiated-babies-at-birth-in-uganda/

Moshiro, R., Mdoe, P., & Perlman, J. M. (2019). A Global View of Neonatal Asphyxia and Resuscitation. Frontiers in Pediatrics, 7, 489. https://doi.org/10.3389/fped.2019.00489

Mubende District. (2025). Health | Mubende District. https://mubende.go.ug/dept/health

Olofsson, P. (2023). Umbilical cord pH, blood gases, and lactate at birth: Normal values, interpretation, and clinical utility. American Journal of Obstetrics and Gynecology, 228(5), S1222–S1240. https://doi.org/10.1016/j.ajog.2022.07.001

Opitasari, C., & Andayasari, L. (2016). Maternal education, prematurity and the risk of birth asphyxia in selected hospitals in Jakarta. Health Science Journal of Indonesia, 6(2), 111–115. https://doi.org/10.22435/hsji.v6i2.4769.111-115

Su, Y.-J., Liu, W., Xing, R., Yu, Z., Peng, Y., & Luo, W. (2024). Prevalence and risk factors associated with birth asphyxia among neonates delivered in China: A systematic review and meta-analysis. BMC Pediatrics, 24(1), Article 1. https://doi.org/10.1186/s12887-024-05316-7

Wayessa, Z., Belachew, T., & Joseph, J. (2018). Birth Asphyxia and Associated Factors among Newborns Delivered in Jimma Zone Public Hospitals, Southwest Ethiopia: A Cross-sectional Study. Journal of Midwifery and Reproductive Health, 6(2), 1289–1295. https://doi.org/10.22038/jmrh.2018.10483

WHO. (2025). A4C49D3. Datadot. https://data.who.int/indicators/i/E3CAF2B/A4C49D3

Woday, A., Muluneh, A., & St Denis, C. (2019). Birth asphyxia and its associated factors among newborns in public hospital, northeast Amhara, Ethiopia. PLoS ONE, 14(12), e0226891. https://doi.org/10.1371/journal.pone.0226891

Workineh, Y., Semachew, A., Ayalew, E., Animaw, W., Tirfie, M., & Birhanu, M. (2020). Prevalence of perinatal asphyxia in East and Central Africa: Systematic review and meta-analysis. Heliyon, 6(4), e03793. https://doi.org/10.1016/j.heliyon.2020.e03793

Zewude, S. B., Ajebe, T. M., Gessesse, S. S., & Wassie, T. H. (2021). Proportion and predictive factors of low apgar score at five minute among singleton term neonates delivered in Debre Tabor specialized hospital, northwest Ethiopia: A cross-sectional study. International Journal of Africa Nursing Sciences, 15, 100322. https://doi.org/10.1016/j.ijans.2021.100322