ArticleBMJ (Clinical research ed.)2000
Risk factors for neonatal encephalopathy in Kathmandu, Nepal, a developing country: unmatched case-control study.
Article in BMJ (Clinical research ed.), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 5 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 5 syntheses or guidelines pooled it, 163 citations in OpenAlex.
- Meconium-stained amniotic fluid.American journal of obstetrics and gynecology · 2023Pooled it
- Effect of intra-partum Oxytocin on neonatal encephalopathy: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2021Pooled it
- Neonatal Encephalopathy With Group B Streptococcal Disease Worldwide: Systematic Review, Investigator Group Datasets, and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Pooled it
- Hemoglobin concentration and pregnancy outcomes: a systematic review and meta-analysis.BioMed research international · 2013Pooled it
- Perinatal asphyxia.BMJ clinical evidence · 2007Pooled it
- Trial
- Antenatal Uterotonics as a Risk Factor for Intrapartum Stillbirth and First-day Death in Haryana, India: A Nested Case-control Study.Epidemiology (Cambridge, Mass.) · 2020Trial
- Use of wind-up fetal Doppler versus Pinard for fetal heart rate intermittent monitoring in labour: a randomised clinical trial.BMJ open · 2015Trial
- Injections during labor and intrapartum-related hypoxic injury and mortality in rural southern Nepal.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2013Trial
- Trial
- Prevalence and risk of adverse intrapartum-related outcomes in Uganda: a cross-sectional study with nested case-control.BMJ open · 2025Article
- The combined impact of meconium stained amniotic fluid and small for gestational age on delivery outcomes.Archives of gynecology and obstetrics · 2025Article
- Risk factors for neonatal hypoxic ischemic encephalopathy and therapeutic hypothermia: a matched case-control study.BMC pregnancy and childbirth · 2024Article
- Therapeutic hypothermia after perinatal asphyxia in Vietnam: medium-term outcomes at 18 months - a prospective cohort study.BMJ paediatrics open · 2024Article
- Application of machine learning to identify risk factors of birth asphyxia.BMC pregnancy and childbirth · 2023Article
- Labor augmentation with oxytocin in low- and lower-middle-income countries: a systematic review and meta-analysis.AJOG global reports · 2022Review
- The association between early-onset sepsis and neonatal encephalopathy.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Risk factors of mortality in neonates with neonatal encephalopathy in a tertiary newborn care unit in Zimbabwe over a 12-month period.PLOS global public health · 2022Article
- Need for more evidence in the prevention and management of perinatal asphyxia and neonatal encephalopathy in low and middle-income countries: A call for action.Seminars in fetal & neonatal medicine · 2021Review
- Risk Factors Associated With Birth Asphyxia in Term Newborns at a Tertiary Care Hospital of Multan, Pakistan.Cureus · 2021Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 3 countries.
Funding
Abstract
objectiveTo determine the risk factors for neonatal encephalopathy among term infants in a developing country.
designUnmatched case-control study.
settingPrincipal maternity hospital of Kathmandu, Nepal. SUBJECTS: All 131 infants with neonatal encephalopathy from a population of 21 609 infants born over an 18 month period, and 635 unmatched infants systematically recruited over 12 months.
main outcome measuresAdjusted odds ratio estimates for antepartum and intrapartum risk factors.
resultsThe prevalence of neonatal encephalopathy was 6.1 per 1,000 live births of which 63% were infants with moderate or severe encephalopathy. The risk of death from neonatal encephalopathy was 31%. The risk of neonatal encephalopathy increased with increasing maternal age and decreasing maternal height. Antepartum risk factors included primiparity (odds ratio 2.0) and non-attendance for antenatal care (2.1). Multiple births were at greatly increased risk (22). Intrapartum risk factors included non-cephalic presentation (3.4), prolonged rupture of membranes (3.8), and various other complications. Particulate meconium was strongly associated with encephalopathy (18). Induction of labour with oxytocin was associated with encephalopathy in 12 of 41 deliveries (5.7). Overall, 78 affected infants (60%) compared with 36 controls (6%) either had evidence of intrapartum compromise or were born after an intrapartum difficulty likely to result in fetal compromise. A concentration of maternal haemoglobin of less than 8.0 g/dl in the puerperium was significantly associated with encephalopathy (2.5) as was a maternal thyroid stimulating hormone concentration greater than 5 mIU/l (2.1).
conclusionsIntrapartum risk factors remain important for neonatal encephalopathy in developing countries. There is some evidence of a protective effect from antenatal care. The use of oxytocin in low income countries where intrapartum monitoring is suboptimal presents a major risk to the fetus. More work is required to explore the association between maternal deficiency states and neonatal encephalopathy.
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