Risk Factors and Outcomes of Perinatal Asphyxia at a Tertiary Hospital in Plateau State, North Central Nigeria: A Case-Control Study

Perinatal asphyxia remains a leading cause of neonatal brain injury and death in Nigeria, yet case-control studies quantifying its risk factors at facility level are scarce. This hospital-based case-control study identifies maternal, obstetric, and intrapartum risk factors for perinatal asphyxia and examines short-term outcomes among neonates delivered at Jos University Teaching Hospital (JUTH), Plateau State, North Central Nigeria. Cases were defined as neonates with an Apgar score below 7 at five minutes or requiring positive pressure ventilation at birth; 156 cases and 312 matched controls were enrolled. Conditional logistic regression was performed to compute odds ratios with 95% confidence intervals. Significant independent risk factors for perinatal asphyxia included prolonged labour above 18 hours (OR 4.7), cord prolapse (OR 8.2), antepartum haemorrhage (OR 5.9), absence of partograph use during labour (OR 3.4), and late antenatal care booking after 28 weeks (OR 2.6). Emergency caesarean section rate was 64.1% among asphyxiated neonates. Hypoxic-ischaemic encephalopathy was classified as moderate or severe in 58.3% of asphyxiated neonates. Short-term mortality among cases was 22.4%, with 31.5% of survivors demonstrating neurological abnormalities at discharge. These findings highlight critical intrapartum care deficiencies. Recommendations include universal partograph use, timely obstetric emergency response, and upskilling of midwives in active labour management. Keywords: perinatal asphyxia, risk factors, case-control, Plateau State, North Central Nigeria.