Factores de riesgo asociados al diagnostico de asfixia perinatal en el Hospital Universitario Mayor Méderi, Bogota, 2010-2011. Thesis

short description

  • Postgraduate thesis

Thesis author

  • Del Riesgo Prendes, Lilia
  • Ibáñez-Pinilla, Milcíades
  • Rincón Socha, Práxedes Isabel

external tutor

  • Del Riesgo Prendes, Lilia
  • Ibáñez-Pinilla, Milcíades

abstract

  • Objective: To determine risk factors for antepartum, intrapartum fetal asphyxia associated with newborns in the neonatal ward of the University Hospital of Bogota Mayor Mederi 2010-2011.Materials and methods: A case-control study matched by date of birth, with a 1:5 ratio (51:306). Associations were assessed using the chi-square Mantel-Haenszel or Fisher test for paired data, with OR and confidence interval of 95%, multivariate analysis with conditional logistic regression model.Results: Risk factors with significant association were: - First delivery: maternal pathological history (OR = 6.00, 95% CI :1.55-23 .19, p = 0.013), primiparity(OR = 1.91, 95% CI :1.02-3 .56, p = 0.090),-Intrapartum: placental abruption (OR = 25.00, 95% CI :2.92-213 .99, p = 0.001), third trimester bleeding (OR = 12.50, 95% CI :2.43-64 .43, p = 0.001), Oligohydramnios (OR = 6.25, 95% CI :1.68-23 .28, p = 0.001), fetal tachycardia (OR = 7.66, 95% CI :1.67-35 .04, p = 0.011), abnormal intrapartum fetal monitoring (OR = 10.33, 95% CI: 4.38- 24.34, p = 0.001), prolonged second stage (OR = 13.00, 95% CI :4.63-36 .46, p = 0.001), maternal fever (p <0.001), chorioamnionitis (p <0.001), maternal seizures (p <0.001), bradycardia fetal (p = <0.001),-Fetal: Male gender (OR = 1.87, 95% CI :1.02-3 .44, p = 0.026), gestational age equal or BALLARD <36semanas (OR = 4.78 (95% CI :2.21-10 .35, p = 0.001), instrumental birth pathway (OR = 18.80, 95% CI :3.69-39 .55, p = 0.001), amniotic fluid or meconium stained bleeding (OR = 9.00, 95% CI :3.01-26 .85, p = 0.001 ), nuchal cord (OR = 9.00, 95% CI :3.59-22 .52, p = 0.001), birth weight equal to or <2500 grams (OR = 8.88, 95% CI :3.73-21 .15, p = 0.001). emphases and hypertensive syndrome associated with pregnancy were found significant in multivariate analysis.Conclusions: Risk factors for perinatal asphyxia were: maternal medical history, primiparity, placental abruption, third trimester bleeding, oligohydramnios, abnormal intrapartum fetal monitoring, fetal tachycardia and bradycardia, prolonged second stage, chorioamnionitis, maternal fever, maternal seizures, gender male BALLARD gestational age equal or <36 weeks, birth way instrumented hemorrhagic amniotic fluid or meconium-stained nuchal cord, birth weight equal to or <2500 grams.

publication date

  • 2013-06-11

keywords

  • Hypoxic - Ischemic encephalopathy
  • Perinatal asphyxia

Document Id

  • b78d05da-a2ae-4869-bb3c-a5215f3a9e16