Abstract

Background: Effective resuscitation at birth can prevent a large proportion of neonatal deaths due to birth asphyxia. Despite these, information on resuscitation intervention success and associated factors were limited. This study assesses resuscitation intervention time to success and associated factors at delivery room of health facilities in eastern part of Ethiopia.

Methods: Cross-sectional direct observation study was conducted from June to October 2016. Newborn breathing at birth had not initiated were involved in the study. Data were collected using a structured questionnaire and checklist. Differences between successful of resuscitation groups for time to events were assessed with the log rank test. The Cox proportional-hazards model was used to assess the predictors associated with resuscitation intervention success. A backward stepwise method was used for selecting variables and those with P ≤ 0.25 were further examined in multivariate analysis.

Results: From the total of 239 resuscitated new-born, resuscitation of 87(36.4%) succeed, 41(17.15%) were died, and 111(46.44%) were referred to another special care. The success of resuscitation among new born were decreased by history of premature rupture of membrane [AHR = 0.51; 95%CI (0.27-0.95)], meconium stained amniotic fluid [AHR =0.44; 95% CI: (0.26, 0.76)]. But the increment of gestational age [AHR = 1.38; 95% CI: (1.16-1.65)],  high Apgar score at first minute [AHR=1.85; 95% CI:(1.41-2.42)], high Apgar score at fifth minute [AHR=1.36; 95%CI: (1.10-1.67)], and second quintile score of wealth index [AHR=3.20; 95%CI: (1.59-6.45)] are the factors that favors success of resuscitation intervention.

Conclusions: Newborn resuscitation success was low in this study. The success of resuscitation is associated with premature rupture of membrane, meconium, gestational age, Apgar score at first and fifth minute and family wealth index score. Early identification and management of the premature rupture of membrane and prolonged labour might help in improvement of the success of resuscitation intervention, and a significantly contributes in effort made for newborn mortality reduction.

Keywords: Neonate, birth asphyxia, resuscitation, success, failed, Harar town, eastern Ethiopia