Our study demonstrates that materna

Our study demonstrates that maternal education, history of stillbirths, prenatal complications (including smelly
or excessive vaginal discharge and anemia) and intrapartum complications (including fever, prolong or difficult
labour, breech delivery, cord around child’s neck, premature delivery, large baby size and failure to establish
spontaneous respiration after birth) were significantly associated with higher risk of neonatal mortality related to
birth asphyxia in Matiari District of Pakistan. To our knowledge, this is the first study to identify risk factors of
birth asphyxia mortality among newborns, conducted in rural resource limited settings in Pakistan, where quality
of care is inadequate to respond to emergency situations. We evaluated broad range of risk factors including socio-
demographic, antenatal, intrapartum and neonatal complications.
Among the sociodemographic risk factors, our study identified maternal education as one of the factors associated
with BA mortality. Similar patterns were reported by other studies conducted in rural areas of Southern
Nepal and Mexico City [27] [28]. Another hospital based study conducted in Bangladesh did not find association
of maternal education with BA [29]. Maternal illiteracy is a very broad indicator of poor socio-economic
conditions associated with consequent malnutrition, frequent pregnancies and also influence care seeking during
antepartum period. Our data also suggests that history of stillbirths is significantly associated with increased risk
of birth asphyxia mortality and this finding is concordance with the findings from studies conducted in similar
settings from less developed countries [30]-[33]. We did not find any association between birth asphyxia related
mortality and maternal age. This finding is consistent with other studies [29] [34].
It is well known that diseases and complications during pregnancy are the most important risk factors of perinatal
mortality [35]-[39]. Among antenatal risk factors, our study showed that antepartum complications (including
smelly or excessive vaginal discharge and anemia or pallor) were the most important factors related to
increased risk of BA mortality. Previous studies have shown similar results [40] [41]. Among intrapartum risk
factors, presence of fever (indicative of infection), prolonged labor, breech delivery and cord around child’s
neck were found to be associated with high BA mortality. These findings are consistent with other studies [27]
[29] [40]-[47]. We did not find any association of BA mortality with convulsions and vaginal bleeding. Other
studies conducted in resource limited settings have reported similar results [27]. However, this could be due to
self-reported and non-specific nature of data.

Results (Indonesian) 1:

Our study demonstrates that maternal education, history of stillbirths, prenatal complications (including smellyor excessive vaginal discharge and anemia) and intrapartum complications (including fever, prolong or difficultlabour, breech delivery, cord around child’s neck, premature delivery, large baby size and failure to establishspontaneous respiration after birth) were significantly associated with higher risk of neonatal mortality related tobirth asphyxia in Matiari District of Pakistan. To our knowledge, this is the first study to identify risk factors ofbirth asphyxia mortality among newborns, conducted in rural resource limited settings in Pakistan, where qualityof care is inadequate to respond to emergency situations. We evaluated broad range of risk factors including socio-demographic, antenatal, intrapartum and neonatal complications.Among the sociodemographic risk factors, our study identified maternal education as one of the factors associatedwith BA mortality. Similar patterns were reported by other studies conducted in rural areas of SouthernNepal and Mexico City [27] [28]. Another hospital based study conducted in Bangladesh did not find associationof maternal education with BA [29]. Maternal illiteracy is a very broad indicator of poor socio-economicconditions associated with consequent malnutrition, frequent pregnancies and also influence care seeking duringperiode antepartum. Data kami juga menunjukkan bahwa sejarah stillbirths bermakna dikaitkan dengan peningkatan risikoKelahiran asphyxia kematian dan temuan ini adalah kesesuaian dengan temuan dari studi yang dilakukan di serupapengaturan dari negara-negara [30]-[33]. Kami tidak menemukan Asosiasi antara kelahiran asphyxia terkaitkematian dan umur ibu. Temuan ini konsisten dengan penelitian lain [29] [34].Hal ini juga diketahui bahwa penyakit dan komplikasi yang terjadi selama kehamilan yang paling penting faktor risiko perinatalkematian [35]-[39]. Di antara faktor-faktor risiko kehamilan, penelitian kami menunjukkan bahwa antepartum (termasuk komplikasibau atau berlebihan keputihan dan anemia atau pucat) adalah faktor yang paling penting berkaitanpeningkatan risiko kematian BA. Studi sebelumnya telah menunjukkan hasil yang sama [40] [41]. Antara risiko intrapartumfaktor, kehadiran demam (indikasi infeksi), lama kerja, sungsang pengiriman dan tali di sekitar anakleher ditemukan untuk dihubungkan dengan BA kematian yang tinggi. Temuan ini juga konsisten dengan penelitian lain [27][29] [40]-[47]. Kami tidak menemukan Asosiasi BA kematian dengan kejang-kejang dan pendarahan vagina. Lainnyastudi yang dilakukan dalam pengaturan sumber terbatas telah melaporkan hasil yang sama [27]. Namun, hal ini dapat karenadilaporkan sendiri dan non-spesifik sifat data.