Birth asphyxia in a rural community of north India.

A community-based inquiry was conducted in a rural area of north India to estimate extent of the problem of birth asphyxia. Births and neonatal deaths were recorded in 54 villages. Trained field workers contacted birth attendants/family members within 15 days after the birth, and recorded the symptoms and signs related to birth asphyxia on a pre-coded questionnaire. Detailed descriptive history of birth events in chronological order was recorded in cases suspected to be asphyxiated or stillborn. Two pediatricians reviewed the case histories independently to assign the diagnosis. Out of the 1977 recorded livebirths, field workers suspected 53 babies to be asphyxiated, 39 of these were diagnosed as asphyxiated, four as not asphyxiated by both the experts, and 10 were considered as asphyxiated by one of the experts. Prevalence of birth asphyxia was estimated to be at least 2 per cent (39/1977). Case fatality in these cases was 74 per cent. The verbal diagnosis method adopted in this study can be used to compare the prevalence of asphyxia in community studies.