TITLE:
Severity, Factors, and Short-Term Outcomes of Neonatal Hypoxic-Ischemic Encephalopathy Due to Birth Asphyxia at a Tertiary Hospital in Tanzania
AUTHORS:
Zaituni Ibrahim Chekachene, Aisa Shayo, Beatrice Ilomo, Baraka Moshi, Irene Patrick Sharau, Denis Penford Machaku, Rune Nathaniel Philemon, Blandina Theophil Mmbaga
KEYWORDS:
Severity, Short-Term, Hypoxic Ischemic, Encephalopathy, Infants, Birth Asphyxia
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.16 No.3,
May
21,
2026
ABSTRACT: Background: Hypoxic-Ischemic Encephalopathy (HIE), with a prevalence of 10.7% - 25.4% in Sub-Saharan Africa, including Tanzania, is a leading cause of neonatal mortality and long-term neurological impairment. Methodology: This prospective cohort study was conducted from October 2023-May 2024, at a tertiary care hospital, enroling all eligible neonates with birth asphyxia who developed HIE. These neonates were consecutively admitted neonatal unit and followed from admission until discharge or death within 28days of life. Maternal, delivery, and neonatal factors were collected via questionnaires, and HIE severity was assessed daily using the Thompson score. Short-term outcomes were defined as survival during hospitalization with hospital stay being less or more than 7days. Data were analysed with STATA 15, with variables categorized as baseline (maternal and perinatal) and post admission. Baseline variables were interpreted as a potential factors for HIE and post admission variables interpreted as indicators of health care access and condition progression. Bivariable logistic regression analysis was performed first, variables with stastical significance (p Results: Out of 1619 deliveries, 121 neonates had birth asphyxia, of whom 88 (72.7%) developed HIE (49% moderate, 35% severe, 16% mild). HIE mortality was 20%, with 72.2% occurring in severe cases. Key neonatal factors for HIE included low birth weight (25 hours. Maternal factors associated with HIE included age 21 - 34 years (75.0%), cesarean delivery (47.7%), multiparity (51.1%), anemia (26.1%), maternal fever (12.5%), twin pregnancy (5.7%) while antenatal care (ANC) visits were protective. Moderate HIE had a 55.7% recovery, with most cases hospitalized for over seven days. Conclusion: HIE prevalence among neonates with birth asphyxia is high at 72.7%, with significant high mortality in severe cases. Early identification of high-risk pregnancies and improved antepartum, intrapartum, and neonatal care can reduce HIE burden, neonatal mortality and future sequelae.