Risk assessment in birth asphyxia.

In developing countries the need for a risk approach in neonatology is obvious because of a high birth rate, high neonatal mortality rate, and limited availability of resources. Quantification of risk, with selected antepartum, intrapartum factors, clinical, and post-mortem findings was done by calculating odds ratio, attributable risk, and 95 per cent confidence limits in 1811 babies, 541 of which were asphyxiated. Primigravidity, history of perinatal death, pregnancy induced hypertension, and antepartum haemorrhage carried higher risk. Abnormal fetal heart rate and meconium passage in amniotic fluid correctly predicted high risk of birth asphyxia. Decreasing risk in premature/low birth weight babies without increase in abdominal deliveries suggested that caesarean sections were unnecessary in preterm deliveries. Clinical monitoring of asphyxiated newborns was adequate enough.