Maternal risk factors in severe newborn asphyxia
DOI:
https://doi.org/10.15574/PP.2025.4(104).1016Keywords:
fetal distress, preeclampsia, obesity, labor induction, multivariate analysisAbstract
Fetal distress during labor is one of the most serious obstetric complications, potentially leading to significant consequences for neonatal health, including hypoxic-ischemic encephalopathy, cerebral palsy, and, in severe cases, perinatal mortality.
Aim - to identify the primary maternal risk factors for severe neonatal asphyxia and to develop a predictive model for the prevention of fetal distress.
Materials and methods. The study included 213 patients. The study group consisted of 98 women whose newborns were diagnosed with severe asphyxia (Apgar score ≤ 3 at the first minute). The control group consisted of 115 patients without a diagnosis of fetal distress. Univariate and multivariate logistic regression models were used to identify the most significant factors.
Results. Univariate analysis revealed an increased risk of fetal distress in the presence of obesity, uterine leiomyoma, preeclampsia, and acute respiratory viral infection (ARVI), while a decreased risk was associated with pre-induction using prostaglandin E2. Multivariate analysis identified preeclampsia, anemia, ARVI during pregnancy, and labor dystocia as significant risk factors.
Conclusions. The resulting multivariate model demonstrates high predictive power, enabling the development of individualized recommendations for fetal distress prevention. Specifically, preeclampsia, obesity, and acute viral infection are critical factors — in this sample, all cases involving these conditions led to fetal distress. Other factors significantly alter the probability of distress: anemia and labor dystocia significantly increase the risk, while multiparity and thyroid pathology were found to have a protective effect.
The study was conducted according to the principles of the Declaration of Helsinki. The protocol was approved by the Local Ethics Committee of the Kyiv Perinatal Center. Informed consent was obtained from all participants.
The authors declare no conflict of interest.
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