Master of Medicine in Pediatrics and Child Health

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http://hdl.handle.net/20.500.12493/14841

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Browsing Master of Medicine in Pediatrics and Child Health by Author "Muhiadin Omar Matan"

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    Prevalence, Severity and Factors associated with Hypoxic Ischemic Encephalopathy among Term Neonates delivered with Low APGAR Score at Hoima Regional Referral Hospital
    (Kampala International University, 2023-03) Muhiadin Omar Matan
    Background: Despite neonatal encephalopathy being a significant problem worldwide and one of the major contributors of long term neurological morbidity and mortality, there are contextual variations in its prevalence, severity and associated factors, particularly those with low APGAR scores. This study determined the prevalence, severity and factors associated with hypoxic ischemic encephalopathy (HIE)among term neonates delivered with Low APGAR Score at Hoima Regional Referral Hospital (HRRH). Method: This was a hospital-based cross-sectional study in Neonatal Intensive care Unit (NICU) at HRRH among 126 neonates. They were consecutively enrolled based on hospital register of NICU between 2nd November 2022 and 10th January 2023. Data on socio demographic, obstetric, and clinical characteristics were collected. Descriptive statistics were presented for all characteristics considered. Prevalence of HIE was presented as a proportion of the neonates with HIE expressed as a percentage. For factors, bivariate and multivariate analyses were conducted. Only factors with p<0.05 at multivariate stage were condidered significant. Severity of HIE was presented as a proportion of the neonates with different categories of HIE among those diagnosed with HIE expressed as a percentage. All analyses were done using IM SPSS 24 Results: Of the 126 neonates with low APGAR enrolled, the prevalence of HIE was 92.1%. The risk of HIE increased significantly for neonates with meconium staining (aOR= 10, 95%CI: 1.197-82.498, p= 0.033) and for neonates born to mothers had prolonged labor, (aOR=5,95%CI 1.082-27.745, p= 0.040). Of the 116 neonates with HIE, the majority had mild HIE, 44.0% followed by severe HIE, 28.5%, and moderate HIE, 27.9%. Conclusions: The prevalence of HIE among term-neonates with low APGAR score at 5th minute at HRRH was high. Most of the neonates delivered with low APGAR score at 5th minute had mild HIE. Prolonged labour and presence of meconium staining in the amniotic fluid increased the odds of HIE at Hoima RRH. It is therefore recommended to pay close attention to women with prolonged labor and those whose amniotic fluid is stained with meconium. Their fetal heart rate should be monitored and timely intervation should be done to prevent hypoxic ischemic encephalopathy. Early communication between the caring obstetrician and neonatology staff in case risk factors are identified.