Study of serum zinc in neonates and their mothers in Shimla Hills (Himachal Pradesh)

Serum zinc level in cord blood of 159 neonates was estimated by atomic absorption spectrophotometer. The cases were classified according to birth weight and gestation of babies as Term appropriate for date (TAFD), Term small for date (TSFD), Term large for date (TLFD), Preterm appropriate for date (PAFD), Preterm small for date (PSFD) and Preterm large for date (PLFD). The zinc level were also estimated in mothers of these groups at the time of delivery, and compared with cord blood levels of those in non-pregnant mothers. Mean serum zinc level in infants born full term AFD, full term SFD, full term LFD, preterm AFD, preterm SFD and preterm LFD were 79.6±17.8 μg/dl, 58.2±13.4 μg/dl, 84.1±21.1 μg/dl, 81±25.2 μg/dl, 51.2±51.7 μg/dl and 76±14.7 μg/dl respectively. The maternal zinc levels in respective groups were 67±9.6 μg/dl, 56.5±7.5 μg/dl, 63.6±14.4 μg/dl, 62.7±21.1 μg/dl, 54.5±5.4 μg/dl, and 58.2±2.7 μg/dl. The mean serum zinc values in mothers and babies in birth weight group ranging from 1500–2000 gm were 55.3±4.3 μg/dl and 60±23.1 μg/dl, 2001–2500 gm were 59.5±11.3 and 65.8±17 μg/dl, 2501–3000 gm were 69.2±9.5 and 84.7±14 μg/dl, 3001–3500 gm were 65.8±12.7 μg/dl, 82.2±20.8 μg/dl and 3501 and above were 70.5±8.2 μg/dl and 85±14.3 μg/dl respectively. Statistically significant low zinc levels were observed in SFD babies and their mothers. The zinc levels in non-pregnant mothers were 82.2±11.6 μg/dl which were significantly higher from the levels obtained for pregnant mothers. Statistically significant low levels were observed in mothers as well as in babies of low birth weight group.     

Free fatty acids and triglycerides in normoglycemic low birth weight newborns in early neonatal period

Free fatty acids, triglycerides and blood sugar were estimated in 45 lowbirth weight which included 24 preterm and 21 small for gestational age term babies, in the cord blood, in the fasting state at 6±1 h of age, and after initiation of sugar water feeds at 24±2 h of age. Thirty six appropriate for gestational age, term newborns were taken as controls. None of the newborns were born to diabetic mothers or had hypoglycemia. Mean cord blood sugar levels in all the groups were similar ranging between 69.55 to 73.7 mg/dl. followed by a fall in all at 6±1 h and subsequent rise at 24±2h. levels were significantly lower in LBW newborns compared to controls. Means FFA levels were lowest in babies with agestation of 28–32 weeks (0.27 m Mol/L), being almost similar to controls (0.35 mMol/L) in preterm 33–36 weeks (0.32 mMol/L) and higher than controls in SGA (0.48 mMol/L). An inverse relationship with blood sugar level was seen in serial estimations. SGA neonates continued to show higher and preterm (28–32 weeks) lowest levels throughout the study period. Triglycerides in cord blood were 36.72 mg/dl, 38.33 mg/dl, 56.23 mg/dl and 40.11 mg per cent in preterm 28–32 weeks, 33–36 weeks, SGA term and controls respectively. Levels showed a steady rise during the study period.     

Serum copper in newborns and their mothers

Serum copper levels in the cord blood of 100 newborns and the respective maternal serum copper at the time of delivery was estimated by atomic absorption spectrophotometer. The cases were classified into term AGA, term SGA, term LGA, preterm AGA and preterm SGA. The mean maternal serum copper level 152.42 ± 2.06 μg/Jdl) was significantly higher than the mean cord serum copper level (39.84 ±1.19 μg/dl). There was positive correlation between the maternal serum copper level and cord serum copper level. The mean serum copper level of term neonates was (44.42 ± 1.26 μgJdl) significantly higher (p < 0.001) than that of preterm neonates (30.30 ± 1.14 μg/dl). There was a positive correlation between cord serum cooper level and gestational age. The mean cord serum copper levels of term AGA, term SGA, preterm AGA and preterm SGA neonates was 45.42 ± 1.44 μg/dl, 39.22 ± 2.45 μg/dl, 31.00 ± 2.11 udJdl and 29.47 ± 2.08 μg/dl respectively. There was no statistically significant difference in the mean serum copper level, of AGA and SGA group of both term and preterm noenates. The difference amongst mean maternal serum copper level of various neonatal groups was not significant.     

Kangaroo Mother Care (KMC) in LBW infants—a Western Rajasthan experience

Objective This study was taken to study the various beneficial effects of KMC in LBW babies. Methods 50 LBW babies (birth weight >2 kg) two who delivered at Umaid Hospital, RIMCH Jodhpur included in this study and they have given KMC 4–6 hours/day in 3–4 settings. Maternal & Neonatal characteristics and complications prospectively recorded. Results Of 50 LBW babies enrolled, M:F ratio was 1.5:1 and mean birth weight was 1.487 ± 0.175kg. The mean age at which KMC started was 4±1.738 days. The mean weight gain was 29 ± 3.52 gms, mean age of discharge 23.6 ± 3.52 days and mean duration of hospital stay was 15.5 ± 11.3 days. Conclusion KMC is effective and safe in stable preterm infants and as effective on traditional care with incubators. KMC because of its simplicity may have a place in home care of LBW babies.     

Cord and maternal serum IgM in IUGR babies

Due to constraints in conducting specific tests for diagnosis of perinatal infection, the present study was carried out to find out the value of cord serum IgM levels as a screening procedure for intrauterine infection in full term intrauterine growth retarded (IUGR) babies. Thirty five consecutively born full term IUGR singleton babies and their mothers (having weight greater than 40 kg, height greater than 145 cm, Hb 8 g/dl and normal blood pressure) formed the study group. Ten full term singleton babies weighing greater than or equal to 3000 g and their mothers served as controls. In the study population both mean cord serum IgM (26.8 mg/dl) and mean maternal serum IgM (142.42 mg/dl) were raised as compared to the mean cord serum IgM (13.76 mg/dl) and mean maternal serum IgM (100.16 mg/dl) of the control group. However, statistically the rise was significant only between the maternal cord serum IgM levels. But all the same, cord serum IgM levels exceeding 20 mg/dl and 30 mg/dl were found in 51.43 and 22.8% of full term IUGR neonates, respectively whereas among the control neonates only 20.0% had levels exceeding 20 mg/dl and none had levels above 30 mg/dl suggesting possible intrauterine antigenic challenge to perinatal infection in higher proportion of IUGR babies. Cord serum IgM levels were also seen to increase with increase in birth weight. Idiopathic IUGR babies having cord serum IgM levels greater than 30 mg/dl should undergo specific immunological tests and follow up.     

Neonatal infections: I—Maternal and cord serum IgG levels in relation to gestation and intrauterine growth

Fifty low birth weight babies (both preterms and intrauterine growth retarded) and their mothers were the subjects of the study. Ten fullterm babies weighing more than 3.0 kg and their mothers served as controls. The cord serum IgG levels were significantly lower in preterm babies compared to fullterm appropriate for gestational age (FT-AGA) and fullterm intrauterine growth retarded (FT-IUGR) babies. The cord serum IgG levels were not significantly different between FT-AGA and FT-IUGR babies. The maternal serum IgG levels were significantly higher than the cord serum IgG levels in preterm group whereas in fullterm AGA and IUGR groups cord serum IgG levels were significantly higher then the maternal serum IgG levels. There was no correlation between maternal and cord serum IgG levels. The cord serum IgG levels were significantly correlated with gestation even after controlling birth weight. The correlation between cord serum IgG levels and birth weight disappeared once qestation was controlled.     

Is a normally functioning gastrointestinal tract necessary for normal growth in late gestation?

It is known that neonates with congenital abnormalities of the intestine tend to be growth-retarded. We wished to explore the hypothesis that normal fetal gut function is needed for normal growth in late gestation. If this is true, then different populations of babies with different congenital gut abnormalities would be expected to have similar impairments of growth and be small at birth. This growth retardation would be more marked in term than in preterm babies and would be independent of other congenital anomalies. To test these hypotheses, we examined 43 babies born with gastroschisis (GS) in Auckland, New Zealand; 69 babies born with GS in Birmingham, England; and 60 babies born with intestinal atresia (IA) in Auckland. For Auckland babies with GS, the mean weight standard deviation score (WSDS) (i.e., birth weight relative to the mean birth weight for gestation) for term babies was lower than that for preterm babies (−0.932±0.180 vs −0.064±0.237, P=0.014). This was also true for Birmingham babies with GS (−0.991±0.193 vs −0.36 ±0.153, P=0.028). For babies with IA, the mean WSDS for term babies was lower than that for preterm babies (−0.627±0.266 vs 0.057±0.211, P=0.034). There was no significant difference between the mean WSDS of babies with and without major congenital abnormalities (−0.402±0.201 vs −0.271, P=0.70). Our results demonstrate that term babies born with GS are significantly growth-retarded compared with premature babies born with GS. Term babies born with a proximal IA are also growth-retarded. This strongly suggests that in late gestation, the normal growth is dependent on a normally functioning gastrointestinal tract that allows exposure of the proximal intestinal mucosa to ingested amniotic fluid. Accepted: 9 December 1996     

Relationship of insulin-like growth factor-I, insulin-like growth factor binding protein-3, insulin, growth hormone in cord blood and maternal factors with birth height and birthweight

BACKGROUND: To determine whether the following factors are related to birthweight or birth height, we measured insulin-like growth factor (IGF)-I, insulin-like growth factor binding protein (IGFBP)-3, insulin and growth hormone (GH) levels in cord blood and also observed the relationship between birthweight, birth height and maternal factors. METHODS: One hundred and ninety-four cord bloods were collected, 106 from males and 88 from females. Three newborns were small for gestational age (SGA), 168 were appropriate (AGA) and 23 were large (LGA); 21 newborns were preterm and 172 were term. RESULTS: Levels of IGF-I and IGFBP-3, measured by enzyme-linked immunosorbent assay, were significantly lower in preterm babies (35.3 +/- 15.1 and 1025.6 +/- 562.8 ng/mL, respectively) than in term babies (61.6 +/- 39.5 and 1252.6 +/- 403.2 ng/mL, respectively; P < 0.01), but neither insulin nor GH levels, measured by radioimmunoassay, showed any significant difference between the two groups (P > 0.05). Among term babies, IGF-I and IGFBP-3 levels were significantly higher in the LGA group (96.1 +/- 34.1 and 1544.7 +/- 418.1 ng/mL, respectively) than in the AGA group (56.4 +/- 37.6 and 1212.8 +/- 383.4 ng/mL, respectively; P < 0.01). Levels of IGF-I and IGFBP-3 showed significant correlation with birthweight and length, respectively (P < 0.01), although GH and insulin levels did not (P > 0.05). There was a significant correlation between IGF-I and IGFBP-3 levels (P < 0.01, r = 0.64), but IGF-I and IGFBP-3 levels showed no relationship with GH or insulin levels. Birthweight correlated significantly with prepartum maternal weight, maternal weight gain and maternal height (P < 0.05), but birth length correlated significantly only with maternal height (P < 0.05). CONCLUSIONS: Our results suggest that fetal growth depends on fetal levels of IGF-I and IGFBP-3 and maternal factors, not on insulin or GH. Levels of IGF-I and IGFBP-3 may not be regulated by insulin alone, but by the complex interactions between several factors, such as insulin, GH and maternal factors.     

Antioxidant levels in cord blood of low birth weight newborns

We evaluated the antioxidant status of 82 healthy term low birth weight (LBW) newborns and equal number of gestation and sex matched controls weighing <2500 g by measuring vitamin A and E, superoxide dismutase, catalase and glutathione peroxidase in cord serum. Levels of vitamin A and E, superoxide dismutase and catalase were significantly lower and glutathione peroxidase significantly higher in LBW babies compared to controls, with the lowest levels found in babies showing more severe growth restriction (<2000 g). We conclude that LBW newborns are deficient in several important antioxidants which may predispose them to higher oxidative stress.     

GROWTH HORMONE RESPONSE TO FEEDING IN TERM AND PRETERM NEONATES

ABSTRACT. Plasma growth hormone concentrations were measured in 248 healthy term and preterm infants. At birth growth hormone concentrations in cord blood from both term and preterm babies were approximately 100-fold higher than those in blood drawn from healthy adults. By the sixth postnatal day basal pre-feed levels had fallen in term neonates by 65% and a marked postprandial rise was apparent; preterm infants did not show this initial fall in preprandial hormone levels nor was any response to feeding seen. However a fall in preprandial concentrations accompanied by the development of postprandial surges in growth hormone occurred during the next 2 weeks so that by 24 days the postprandial rise was similar to that of term neonates on the sixth day. We conclude that although the initial postnatal changes in plasma growth hormone concentrations are different in preterm and term infants, feeding is a major stimulus to growth hormone secretion in both groups of neonates. Further work is needed to define the precise role of this hormone in neonatal metabolic adaptation.     

1~24月婴幼儿胰岛素样生长因子-1水平及与生长发育的关系

目的：分析1~24月龄婴幼儿血清胰岛素样生长因子-1（IGF-1）水平及其与生长发育的关系。方法：525名健康婴幼儿入选本研究（早产儿125名,足月儿400名）,测量体重/身长,酶联免疫吸附法检测血清IGF-1水平。结果：早产组婴儿期血清IGF-1水平在生后1.5月为最低（86±60 ng/mL）,此后一直维持较高水平,生后4~12月显著高于足月组。足月组婴儿期血清IGF-1水平在生后1.5月为最高(116±52 ng/mL),此后缓慢下降,生后8月时降至最低（69±58 ng/mL）。不论是早产儿还是足月儿体重/身长SDS与血清IGF-I水平均存在着正相关关系。结论：血清IGF-1水平均与婴幼儿期生长发育速度密切相关。［中国当代儿科杂志,2010,12（6）：459-461］     

A study of serum zinc levels in cord blood of neonates and their mothers

Serum zinc was estimated in the cord blood of 60 neonates of different gestational age and birth weight, and their mothers. Mean serum zinc levels in neonates FTGA, PTAGA and term SGA were 128.88±14.37, 94.32±17.79 and 111.8±9.2 ug/dl respectively. The maternal serum zinc levels in corresponding groups was 96.28±19.48, 115.44±15.41 and 93.8±7.62 ug/dl. Thus mean serum zinc level in cord blood of FT AGA newborns was significantly higher than that in PT AGA and FT SGA. Mean serum zinc level in mothers of FT AGA was significantly lower than that in mothers of PT AGA. However, there was no significant difference between the maternal serum zinc levels of FT AGA and FT SGAs. There was positive correlation between gestational age and serum zinc level in cord blood of AGAs while correlation was negative in case of their mothers. There was positive correlation between weight (keeping gestational age constant) and serum zinc level in case of neonates while corresponding maternal zinc levels did not vary. (FT AGA and FT SGA).     

Immune status of low birth weight babies

An attempt was made to evaluate the humoral and cellular immune status of preterm and small for dates babies born at All India Institute of Medical Sciences Hospital. The study sample included 24 term small-for-dates babies and 12 preterm babies (gestation of less than 37 weeks) and 20 term appropriate-for-dates babies who served as controls. The small-for-dates babies were subdivided into the following 2 subgroups on the basis of severity of intrauterine growth retardation (IUGR): mild IUGR -- babies weighing between 3rd and 10th percentile for their gestation; and severe IUGR -- babies weighing less than 2 S.D. or 3rd percentile for their gestation. The levels of immunoglobulin G (IgG), M (IgM), and A (IgA) were determined in the cord blood using the single radical diffusion technique. The B-lymphocytes were identified and counted by the surface membrane immunoglobulin (SmIg) using immunofluorescence technique. The cellular immune response was assessed by counting T-lymphocytes by E-rosette technique employing sheep red blood cells. The neonates with severe IUGR and preterm babies had significantly lower levels of IgG. The levels of IgM and IgA did not differ significantly in the 4 groups. The preterm babies had significantly higher percentage of B-lymphocytes though the absolute count was not significantly different from normal newborn babies. The absolute count B cells was significantly low in babies with severe IUGR. The babies with severe IUGR had significantly low absolute and percentage count of E-rosette forming cells as compared to normal newborn babies. The findings suggest that low birth weight babies with severe IUGR are at a greater risk to develop bacterial infection due to deficiency of both humoral and cellular immune host defenses. In contrast, preterm babies are immunologically competent though passively transferred maternal IgG levels are low. It is desirable to study the duration of immunodeficiency caused by severe IUGR and its reversibility on nutritional rehabilitation. In view of the wide prevalence of IUGR in India it is possible that inadequacy of cell mediated immune response in these infants may be associated with poor "takes" following at birth BCG and small pox vaccinations. The vaccination schedule may have to be modified depending upon the duration of immunodeficiency in babies with IUGR.     

Neonatal mechanical ventilation—Experience at a level II care centre

One hundred and fifty nine neonates were ventilated over a period of one year of whom 74 (46.54%) survived. This study aims to analyse the indications, complications and outcome of babies requiring mechanical ventilation. The early outcome measures were (i) survival rate with respect to birth weight, gestation and indication of ventilation, and (ii) Complications of assisted ventilation. One hundred and forty seven babies received IPPV and 34 received CPAP. Twenty two out of these 34 required IPPV later. Survival was cent percent on exclusive CPAP mode. HMD was the commonest indication for ventilation followed by Birth asphyxia, Apnea of prematurity, Meconium Aspiration Syndrome and Persistent Pulmonary Hypertension of the New born. Survival rates increased with increasing birth weight and gestational age, changing from 25% for <1000 gm and 20% for <28 wks to 53% for >2500 gms and 50.2% for >37 wks. Prolonged ventilatory support was needed for HMD (mean 114 hrs) and PPHN (mean 156 hrs). Commonest complication was Sepsis (26%) followed by Pulmonary hemorrhage, Pneumothorax and IVH. Lower success rates in ventilation is due to the poor survival of babies weighing <1000 gms and those with a gestation of <28 wks with nosocomial infections as a major complication of assisted ventilation being an additional factor.     

Serum zinc and copper levels in the maternal blood and cord blood of neonates

Estimation of serum zinc and copper in the maternal blood and cord blood of neonates was carried out to correlate the trace metals in the neonates and their mothers in relation to gestational age and birth weight. Sixty-five healthy neonates, both term and preterm and their mothers were selected. This cross sectional study was done at Azimpur Maternity Centre, Dhaka Medical College Hospital and Chemistry Division, Atomic Energy Centre, Dhaka, Bangladesh from July 1997 to June 1998. The estimation of trace metals was carried out by Atomic Absorption Spectrophotometry (AAS). The mean serum zinc levels in the maternal blood and cord blood were 0.47 ± 0.24 μg/ml and 0.85 ± 0.33 μg/ml respectively and the mean copper levels in the maternal blood and cord blood were 1.37 ± 0.62 μg/ml and 0.31 ± 0.32 μg/ml respectively. Cord blood zinc level was significantly higher and cord blood copper level was significantly lower than the corresponding maternal blood levels. There was no significant correlation between gestational age and serum zinc levels in the cord or maternal blood. But significant inverse correlation was found between gestational age and serum levels of copper in the maternal and cord blood.     

Fecal sodium and potassium losses in low brith weight infants

We measured 24-hour fecal losses of sodium (Na) and potassium (K) in immediate post natal period of preterm neonates to determine the role of this route in the electrolyte imbalances seen in such infants. The values from preterm infants were compared to a group of age matched term infants. Eleven studies were done on unfed extremely low birth weight infants (group I, birth weight <1200 gms), seven on fed preterm infants (group II, birth weight 1201–2500 gms) and nine on fed term infants (group III, birth weight 2501–4000 gms). Measured and derived variables compared between the groups were 24 hour fecal volume, total fecal electrolyte contents, Na or K lost per kg of body weight and per gm of stool and Na or K losses as percent of intake. Although 24 hour fecal volume was lowest in group I, none of the variables related to Na differed between groups I and II whereas all of them were significantly lower in group I when compared with group III. Groups II and III differed only in terms of Na loss/gm stool which was lower in the previous group. Conversely K loss/gm of stool was significantly higher in group I when compared with both groups II and III and the only variable that differed between groups II and III was a higher fecal K content as fraction of intake. Fecal K/Na ratio was highest in group I, and decreased progressively with advancing gestational age, whereas creatinine clearance was lowest in group I and increased along with gestational age. Serum electrolyte levels were normal, although serum Na concentration was lowest in group I and serum K concentration highest in group II. We conclude that very low birth weight infants have relatively higher fecal K concentrations in the first week of extrauterine life, and speculate that this might have physiological significance as these infants are prone to hyperkalemia during this period.     

Neonatal mortality rate: a hospital study

The 72 neonatal deaths (0-28 days) out of 1533 live births occurring over the January 1-December 31, 1985, period provided the data for this study designed to determine the pattern of neonatal mortality in Varanasi, India. The overall mortality rate was 4.69%. The mortality in preterm (PT) and fullterm (FT) infants was 28.19% and 1.42%, respectively, a statistically significant difference. The overall neonatal mortality in low birth weight infants was 11.65% compared to 1.08% in babies weighing 2500 g or more. The neonatal mortality in PT and FT low birth weight infants was 29.60 and 2.41%, respectively; these differences were statistically significant. Of 72 neonatal deaths, 53 were PT and 19 FT infants. 59.72% of the total deaths were due to severe birth anoxia; septicemia (including meningitis and chest infection) was responsible for 6.94% deaths. Intraventricular hemorrhage was responsible for 25.0% of deaths and was limited only to preterm babies.     

Growth hormone in Intra-uterine growth retarded newborns

Objective To study growth hormone levels in IUGR and healthy controls and its association with birth weight and ponderal index. Methods We studied 50 Intra uterine growth retarded (IUGR) and 50 healthy newborns born at term by vaginal delivery in JIPMER, Pondicherry, India. Cord blood was collected at the time of delivery for measurement of growth hormone. Results When compared with healthy newborns, IUGR newborns had higher growth hormone levels (mean ± SD, 23.5 ± 15.6 vs 16.2 ± 7.61 ngm/ml, P = 0.019). A negative correlation was identified between growth hormone levels and birth weight (r² = − 0.22, P = 0.03) and ponderal index (r² = − 0.36, P = 0.008). Correlation of growth hormone levels was much more confident with ponderal index than with birth weight. Conclusion At birth IUGR infants display increased growth hormone levels which correlate with ponderal index much more confidently than with birth weight.     

Incidence, clinical spectrum, and outcome of intrauterine infections in neonates

A prospective study was undertaken on the incidence of intrauterine infections by screening 1302 cord blood samples for total IgM by radial immunodiffusion. Specific IgM against cytomegalovirus (CMV), rubella and Toxoplasma were estimated in cord blood samples found to contain total IgM > 20 mg/dl. All these neonates were examined at birth and at discharge. Cord blood samples with total IgM > 20 mg/dl were further screened for specific IgM against rubella, CMV and Toxoplasma. Neonates found to have positive specific IgM were followed-up for hearing, opthalmological and developmental assessment. Raised cord blood (IgM > 20 mg/dl) was found in 270/1302 (20.6 per cent). Mean birth weight was comparable in babies with raised (> 20 mg/dl) or low (< 20 mg/dl) cord blood total IgM. Incidence of prematurity and low birth weight were not statistically different in babies with raised cord blood IgM when compared to those with low cord blood IgM levels. Similarly, incidence of intrauterine growth retardation (IUGR) idiopathic was similar in two groups. Specific IgM for rubella was found to be positive in eight (0.6 per cent). Of these, three had symptomatic rubella infection. Two mothers of these symptomatic babies had exanthematous viral illness during first trimester. Specific IgM for CMV was found to be positive in 23 (1.8 per cent) while two infants had symptomatic CMV disease. None of the babies was found to have specific IgM against Toxoplasma. One baby with symptomatic CMV disease and one with rubella died. Another baby with symptomatic CMV disease developed neonatal hepatitis which improved on follow-up but the infant went on to develop sensorineural deafness. All other asymptomatic babies with specific IgM positive against rubella and CMV were found to have normal vision, hearing and development on follow-up.     

Foetal co-relates and mode of delivery in asphyxia neonatorum

A prospective study was conducted on consequitively born live births for determining the role of certain foetal factors and mode of delivery on asphyxia neonatorum. The difference in the incidence of neonatal asphxia in 1208 singleton births (8.5%) and in the 66 multiple births (9.7%) was statistically significantly (p<0.01). Among the singleton live births a significantly increased incidence of asphyxia was recorded in preterms when compared to term and post term babies collectively (p<0.001). Small for date babies were at a greater risk for asphxia neonatorum when compared to babies weighing appropriate for gestational age (p<0.001). An inverse relationship was observed between birth weight and asphyxia neonatorum. A significant difference was seen in the occurrence of neonatal asphyxia between babies weighing <2000 g. and those weighing more than 2000 g. (p<0.001). The incidence was significantly influenced by mode of delivery, being highest in vaginal breech delivery followed in decreasing frequency by forceps and normal vaginal delivery. Among vaginal breech delivered neonates those weighing ≥2500 g were at the highest risk. Evidence of foetal distress and meconium stained amniotic fluid had a low predictability of asphyxia being 35.0% and 40.0% respectively though both were statistically significant (p<0.001).