Birth Injuries, Risk Factors and Predictors of Outcome in Maiduguri North-eastern Nigeria

Abstract

Introduction: Birth injuries are impairment of neonatal body function sustained by the baby at birth which can be avoidable and unavoidable. Despite advances in prenatal care, birth injuries occurs especially in prolonged and difficult labour /deliveries. Objectives: The study aimed to determine the risk factors and predictors of outcome at Special Care Baby Unit of the University of Maiduguri Teaching Hospital Maiduguri, North-Eastern Nigeria. Patients and Methods: This was a prospective cross-sectional studies conducted over 12 months from 1st January to 31st December 2016. Patients who met the inclusion criteria after obtaining ethical clearance were evaluated after consenting to participate in the study. Results: Sixty one (5.7%) out of 1078 neonates admitted to Special Care Baby Unit (SCBU) with birth injuries were recruited into the study. The common risk factors identified were primiparity 25/61 (40.7%) p=0.017, mode of delivery spontaneous vaginal delivery 36/61 (58.8%). Deliver at tertiary centre was high 38/61 (62.3%), though not statistically significant. When compared neonates with one- two birth injuries  compared to those greater than 2 birth injuries delivery by non-obstetrician was associated with higher risk of birth injury p=0.001. Facial nerve palsy, Erb’s palsy was the common central nervous system injury; perinatal asphyxia was higher 24/61 (39.1%). Soft tissue injury constituted the majority; Facial and skin bruises 37/61 (60.7%), sub-conjunctival haemorrhage 25/61 (40.1%) cephalhaematoma and subgaleal haemorrhage was 10/61 (16.4%) and 8/61 (13.1%) respectively. Clavicular fracture was the commonest 5/61 (8.2%), followed by humerus 4/61 (6.6%). Two patients with liver and splenic rupture died within 2 days of admission. Conclusion: The risk factors and predictors of birth injuries are intertwined; largely birth injury is avoidable with good antenatal care and prompt management of labour processes by trained personnel.