Psychomotor development was likewise higher in the EDI group, in this case for both the children with (effect size = 5.4) and without (effect size = 6.1) birth asphyxia, compared to those in the control condition.
In Bangladesh, approximately 5% of newborn infants exhibited signs of intrapartum asphyxia, compared with 2.5% in India.
Unadjusted analyses using the pooled data show evidence to support the double hit hypothesis: there was a significant increased likelihood of early neonatal death in births with maternal fever and intrapartum asphyxia compared to those with signs of intrapartum asphyxia alone (OR: 1.63, 95% CI: 1.12 – 2.65).
As detailed elsewhere [ 32, 33], mental development at 36 months of age was better in children with birth asphyxia who had received the EDI compared with those in the control condition (effect size = 4.6 points on the standardized scale from the Bayley Scales of Infant Development, see below), but there was no difference between trial conditions in the children without birth asphyxia.
We aim to test the 'double-hit' hypothesis that maternal infection in the perinatal period predisposes to neurodevelopmental sequelae from an intrapartum asphyxia insult, increasing the likelihood of an early neonatal death compared with asphyxia alone.
Regarding specific causes of newborn deaths, the commonest cause was severe birth asphyxia associated with severe obstructed labor for 120 newborns (19.2%).
Based on morbidity, birth asphyxia was ranked significantly lower by residents compared with consultants (p < 0.001).
However, birth asphyxia was ranked significantly lower by residents compared with professors (p = 0.023) or consultants (p = 0.026).
Other major direct causes are preterm delivery and birth asphyxia, with low birth weight and hypothermia representing important contributing factors in many deaths [ 4- 6].
