Risk Factors Associated with Birth Asphyxia among Neonates in Maternity Teaching Hospital/Erbil City: A Case-Control Study

Suham Omar Azeez; Shukir Saleem Hasan

doi:10.15218/ejnm.2026.02

Authors

Suham Omar Azeez Department of Nursing, Raparin Teaching Hospital for Children, Erbil, Kurdistan Region, Iraq.
Shukir Saleem Hasan Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Kurdistan Region, Iraq.

DOI:

https://doi.org/10.15218/ejnm.2026.02

Keywords:

Newborn, Risk Factors, Asphyxia, Case-Control Study, Morbidity

Abstract

Background and Objectives: Birth asphyxia is a critical condition characterized by the inability to begin and sustain breathing at birth. It is a leading cause of neonatal morbidity and mortality worldwide. This study aims to investigate the common risk factors for birth asphyxia in Erbil City.

Method: Matched case-control study was conducted from 1st October 2024 to 15th of Jan 2025 at Maternity Teaching Hospital in Erbil city, Iraqi Kurdistan Region, Data were collected through a questionnaire format and direct interview with the mothers of neonates diagnosed with birth asphyxia. The study recruited 276 neonates (92 neonates with birth asphyxia as a case group and 184 neonates without birth asphyxia as a control group). Newborns with congenital anomalies, congenital heart disease, premature babies (<35weeks), and epilepsy family history were excluded from both groups. The study utilized SPSS Version 27 for data analysis, employing chi-square to identify associations between case and control groups and univariate and multivariate logistic regression to identify risk factors independently associated with asphyxia, with a P-value of ≤ 0.05 considered significant.

Result: Risk factors were identified by the study and divided into antepartum and intrapartum maternal periods. Asphyxia was significantly linked to poor socioeconomic position, maternal illiteracy, number of gravidas with P- value of (0.022, 0.011, 0.006) and emergency caesarean section %35.9 with a very high significant P-value (<0.001). After adjusted factors like hypertension, infection, and polyhydramnios, they are associated with increased risks of asphyxia during pregnancy with odds ratios of 3.109, 2.168, and 3.024. And preterm premature rupture of membrane, difficult labour, prolonged second stage of labour, and fetal distress are associated with increased risks of asphyxia during labor with odds ratios of (4.906, 5.116, 6.739, and 8.685, respectively) at a significant level of <0.05.

Conclusion: The study concluded that factors such as socioeconomic status,.....

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