To compare the outcome (early) of neonates with birth asphyxia in-relation to place of delivery and age at time of admission.

OBJECTIVE To determine the frequency of birth asphyxia and short-term (early) outcome in relation to age at admission and place of delivery. METHODS A descriptive cross-sectional study was conducted in the Paediatric Department, Neonatal Ward of Liaquat University Hospital (LUH) Hyderabad from January to December 2009. All babies were received at our nursery or delivered in LUH with birth asphyxia were included, while babies having major congenital abnormalities, with birth weight < 1800 gm or preterm were excluded. After consent and enrollment their detailed history including peri-natal history, Apgar score, resuscitation measures, problems and outcome were recorded on a pre-designed study proforma. Short-term outcome was measured after 7 hours as clinically improved, developed neurological disability (Hypoxic Ischaemic Encephalopathy stage II or III) or death. RESULTS The frequency was (n = 600; 25%) of LUMHS born and (n = 310; 61.63%) were received within 6 hours, (n = 272 45% were LUMHS born and n = 7 7% were out born), (n = 37; 38.95%) within 24 hours and (n = 9; 10.3%) after 24 hours. On initial neurological evaluation (n = 90; 15%) were normal while clinical signs of HIE were present in 85%, with (n = 180; 30%) in stage I, (n = 210; 35%) in Stage II and (n = 120; 20%) in stage III of HIE. Outcome was measured after 72 hours, around 53.3% (320) were normal, 31.6% (190) developed neurological disability, while 15% (90) babies expired. Outcome was better in Liaquat University of Medical Health Sciences (LUMHS) born than out-born with statistically significant difference in terms of disability (Chi-square test P-value < 0.0001) but no difference was noted in terms of disability to death. There was a statistically improved outcome for babies received within 6 hours than those after 6 hours of birth (Chi-square test P-value < 0.0255). CONCLUSION Early recognition of birth asphyxia and timely referral to tertiary center can reduce morbidity and mortality.