Birth Asphyxia: Clinical Presentation and Short-Term Outcomes in a Neonatal Unit

Abstract

Background Birth asphyxia is a major cause of neonatal morbidity and mortality and remains a significant public health concern in developing countries. Early recognition of clinical manifestations and associated outcomes is essential for improving neonatal survival and reducing complications. Methods This prospective observational study was conducted in the Department of Paediatrics at Barrister Rafique-ul-Huq Medical College and Hospital, Dhaka, from July 2025 to June 2026. A total of 210 neonates diagnosed with birth asphyxia and admitted to the neonatal unit were enrolled using purposive sampling. Data regarding demographic characteristics, maternal and perinatal risk factors, clinical presentations and short-term outcomes were collected and analyzed using SPSS version 25.0. Results Among the 210 neonates, 119 (56.7%) were male and 132 (62.9%) were term births. Hospital delivery was reported in 143 (68.1%) cases. Prolonged labor (33.8%) and meconium-stained liquor (30.5%) were the most common associated risk factors. Poor cry at birth (80.0%), delayed initiation of respiration (73.3%) and hypotonia (66.2%) were the predominant clinical presentations. Most neonates (59.0%) were discharged without major complications. Hypoxic-ischemic encephalopathy occurred in 70 (33.3%) neonates, including 18 (8.6%) cases of severe HIE. Mechanical ventilation was required in 73 (34.8%) cases, while sepsis developed in 46 (21.9%) neonates. The mortality rate was 7.6%.