{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:12:29Z","timestamp":1788502349536,"version":"build-2803163510"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Birth asphyxia remains a leading cause of neonatal mortality and morbidity in low- and middle-income countries. In Kenya, it accounts for approximately 29% of neonatal deaths despite the implementation of national newborn care guidelines. This study investigated the risk factors associated with birth asphyxia at Pumwani Maternity Hospital, Nairobi, Kenya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A matched case-control study was conducted at Pumwani Maternity Hospital, Nairobi, Kenya, between February and September 2024. Cases were newborns with a five-minute APGAR score &amp;lt;7, while controls had a five-minute APGAR score \u22657. A total of 540 newborns (270 cases and 270 controls) were consecutively recruited. Data were collected using a researcher-administered questionnaire and a data abstraction tool. Univariable and multivariable conditional logistic regression analyses were performed to identify factors associated with birth asphyxia. All analyses were conducted using R version 4.5.1 (2025-06-13 ucrt), and statistical significance was set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most mothers were aged above 20 years (80.2%), married or cohabiting (75.6%), unemployed (61.9%), and had attained secondary level education (58.0%). Complications during labour were strongly associated with birth asphyxia (AOR: 24.26; 95% CI: 7.65\u201376.95). Additionally, previous adverse obstetric history (AOR: 2.18; 95% CI: 1.14\u20134.17), maternal medical and obstetric conditions during pregnancy (AOR: 1.82; 95% CI: 1.04\u20133.19), and non-cephalic fetal presentation (AOR: 8.92; 95% CI: 1.77\u201345.00) were also independently associated with higher odds of birth asphyxia. Conversely, spontaneous onset of labour (AOR: 0.20; 95% CI: 0.05\u20130.76), spontaneous vaginal delivery (AOR: 0.02; 95% CI: 0.00\u20130.10), and delivery conducted by trained healthcare providers were associated with reduced odds of birth asphyxia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Birth asphyxia was strongly associated with several maternal and obstetric factors. Strengthening antenatal risk identification, timely management of labour complications, skilled intrapartum care, and early recognition of high-risk deliveries may reduce the burden of birth asphyxia and improve neonatal outcomes in similar low-resource settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1886479","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:28:56Z","timestamp":1788499736000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors associated with birth asphyxia at Pumwani Maternity Hospital, Nairobi, Kenya: a case-control study"],"prefix":"10.3389","volume":"14","author":[{"given":"Ruth","family":"Wagathu","sequence":"first","affiliation":[{"name":"School of Nursing and Midwifery, Aga Khan University","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Orwa","sequence":"additional","affiliation":[{"name":"Department of Population Health, Aga Khan University","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peterson","family":"Kiraithe","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Aga Khan University","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abednego","family":"Ongeso","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Aga Khan University","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evah","family":"Maina","sequence":"additional","affiliation":[{"name":"School of Pharmacy and Health Sciences, United States International University","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Gerald","family":"Omondi","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Aga Khan University","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benard","family":"Mutwiri","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Aga Khan University","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Guetterman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Michigan","place":["Ann Arbor, MI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"B1","year":"2023"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e0255488","DOI":"10.1371\/journal.pone.0255488","article-title":"Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: a systematic review and meta-analysis","volume":"16","author":"Ahmed","year":"2021","journal-title":"PLoS One"},{"key":"B3","doi-asserted-by":"publisher","first-page":"4367248","DOI":"10.1155\/2020\/4367248","article-title":"Prevalence and associated factors of perinatal asphyxia in neonates admitted to ayder comprehensive specialized hospital, northern Ethiopia: a cross-sectional study","volume":"2020","author":"Gebregziabher","year":"2020","journal-title":"Int J Pediatr"},{"key":"B4","volume-title":"CWG. 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