Determinants Of Birth Injuries Among Neonates Born In Public Health Facilities Of Ambo Town, Oromia, Ethiopia, 2023: Unmatched Case-Control

Abstract

Background: Birth injury (BI) is as an impairment of the neonate‟s body function or structure due to an adverse influence that occurred during labor and delivery. In Ethiopia, intra-partum related complications‟ including birth injury has become the leading cause of neonatal morbidity and mortality, accounting around one third of neonatal mortality. Objective: The aim of the study is to identify the determinants of birth injury among neonates born in public health facilities of Ambo town, Oromia, Ethiopia, 2023. Methods: A facility based unmatched case control study was employed at public health facilities of Ambo town, Oromia Region, Ethiopia from April 21 to June 20/2023. A systematic random sampling technique was used to select controls (n=236). Cases were any physical injury to parts of the new-borns during the entire birth process that can be visible and identified by clinical evaluation while Controls were new-borns delivered at term pregnancy without physical injury. Case to controls ratio was 1 to 2. The data was collected through interview, direct clinical observation and maternal card review. The data was entered into EpiData version 3.1 then, exported to SPSS version 21 for further analysis. Descriptive statistics, bivariate and multivariable binary logistic regression analysis was carried out for data analysis. Finally, statistical significance was determined based on the odds ratio with its 95% confidence interval and p-value <0.05. Result: In this study, a total of 354 new born (118 of cases and 236 of controls) were included in the analysis. Primiparous mothers (AOR: 2.5; 95%CI (1.5, 4.1)), cephalopelvic disproportion (AOR: 2.8; 95%CI (1.1, 7.0)), instrumental delivery (AOR: 5.1; 95%CI (1.8-8.6)), chronic DM (AOR: 3.9; 95%CI (2.1, 7.3)) and fetal malposition (AOR: 3.4; 95%CI (2.0, 5.9)) were independent determinants of birth injury in this study. Conclusion and recommendation: This study has found out that primiparous mother, cephalopelvic disproportion, instrumental delivery, maternal chronic diabetes mellitus and fetal malposition were found to be independent determinants of birth injury. Birth attendants should give due emphases to careful use of instrument (forceps and vacuum) during delivery and avoid injury to the new-borns is recommended