Factors associated with birth injuries in neonates admitted to the neonatal intensive care unit: a retrospective study in a Ghanaian tertiary care setting

Background: A birth injury is structural damage or functional deterioration of the neonate’s body due to a traumatic incident at birth. The prevalence and the type of birth injury vary from place to place. There is paucity of data on the prevalence of birth injuries in Ghana. Objective: The study aimed to determine the prevalence and factors associated with birth injury in neonates admitted in a tertiary institution in Northern Ghana. Methods: This was a quantitative retrospective study carried out on neonates admitted to the neonatal intensive care unit (NICU) of the Tamale Teaching Hospital between January 2018 through December 2019. Results: Out of 5590 neonates admitted to the NICU, 205 were noted to have various forms of birth injury corresponding to a prevalence of 3.66%(37 per 1000 neonates admitted to our unit). Majority were male (n=123/205, 60.0%), most deliveries occurred in the study hospital(n=143/205, 69.75%), and spontaneous vaginal delivery accounted for 70.73% (n=145/205). Extracranial injuries (n=146/221, 66.06%) were the most common form of birth injury. Next was musculoskeletal injuries (n=41/221, 18.55%) with humeral fractures (n=15/221, 6.78%) being the most frequent in this category. Among the neonates with birth injuries there were 23 deaths recorded (11.22%) all but one of whom had associated birth asphyxia. Birth injuries were significantly associated with place of delivery(p=0.029). Out-born babies were more likely to have extracranial injuries (adjusted odds ratio,5.10; 95% CI: 1.53-16.94;p=0.008). Conclusion: Extracranial injuries were the most common in this study. Place of delivery was significantly associated with birth injuries. Building the capacity of health care professionals is essential to reduce incidence of birth injuries. Some of these injuries can be avoided if high risk pregnancies are referred early to institutions that have the resources and skill to deliver such babies.

Incidence, Pattern and Outcome of Birth Injuries as Seen in a Tertiary Hospital in Southern Nigeria

Introduction: Birth injuries although inevitable should be avoided to prevent unnecessary neonatal morbidities and mortalities as well as hospital litigations. Aim: To determine the incidence rate, pattern and outcome of birth injuries occurring in the Rivers State University Teaching Hospital. Materials and Methods: An observational prospective study was carried out in the Special Care baby Unit of the hospital. A pre tested proforma was used to collect demographic and pregnancy information from mothers and demographic data, delivery history, type of birth injury and clinical outcome from babies whose parents consented to the study. Results: Thirty-nine of the 5,692 babies delivered during the study period had birth injuries, giving an incidence rate of 6.9 per 1000 live births. The common birth injuries were neurological (26.2%), extracranial (23.8%) and soft tissue injuries (21.4%). Cephalopelvic disproportion (36%), diabetes mellitus in pregnancy (32%) and prolonged labour (20%) were commonly found complications of pregnancy among mothers whose babies had birth injuries. Birth injuries were commoner among males, babies born by normal vaginal delivery and those with birth weights between 2.5-3.9Kg. Neurological injuries were significantly associated with normal vaginal delivery and birth weights of ≥ 4kg while soft tissue injuries were significantly associated with Caesarean section, P value < 0.05. Although majority of them were discharged, mortality rate was 7.7%. Conclusion: Although the incidence of birth injury in this study was low, the morbidity and mortality associated with it are avoidable. Improved antenatal and delivery services are therefore necessary to reduce the incidence of birth injuries. Keywords: Birth injury; Incidence; Pattern; Outcome; Tertiary hospital; Nigeria.