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Abstract

Background: Birth asphyxia is a significant cause of neonatal illness and death, particularly in developing countries. One of the most serious consequences of asphyxia is neurological injury, which can lead to long-term complications. Despite its clinical importance, there is limited local data on the types and frequency of these complications in affected newborns. Objective: This study aimed to assess the frequency of neurological complications among neonates with birth asphyxia admitted to a tertiary care hospital in Hyderabad. Methods: This cross-sectional study over a six-month period from January 2025 to June 2025 at the Department of Pediatrics, Isra University Hospital. A total of 195 term neonates (≥ 37 weeks gestation) presented with birth asphyxia were included through consecutive sampling. Information was collected on seizures, tone abnormalities, feeding difficulties, and neonatal reflexes. Associations between neurological findings and demographic variables such as gender, gestational age, and residence were evaluated using chi-square tests, with p-values less than 0.05 considered significant. Results: Out of 195 neonates, 39 (20%) developed seizures, 32 (16.4%) showed changes in tone, 30 (15.4%) had feeding difficulties, and 38 (19.5%) exhibited abnormal neonatal reflexes at the time of discharge. Male infants were more likely to present with abnormal reflexes compared to females (p = 0.01). A significant association was also observed between urban residence and abnormal tone (p = 0.01). Other demographic variables did not show significant correlations. Conclusion: Neurological complications are commonly observed in neonates with birth asphyxia, with seizures and abnormal reflexes being particularly frequent. Male gender appears to be associated with increased vulnerability. These findings highlight the importance of early neurological evaluation and follow-up in asphyxiated infants to prevent long-term disability.