Abstract
The current study was designed to investigate the perinatal risk factors for low 1-min Apgar scores in term neonates. We retrospectively analyzed the maternal and neonatal clinical data of 10,550 infants who were born through vaginal delivery from 37 weeks 0 days to 41 weeks 6 days of single gestation from January 2013 to July 2018. Because the 1-min Apgar score reflects neonatal status at birth, we analyzed the risk factors for low (score <7) 1-min Apgar scores through logistic regression. Among these 10,550 neonates, 339 (3.2%) had low (score <7) 1-min Apgar scores. Among them, 321 (94.7%) were admitted to the neonatology department for further observation or treatment. Multivariate analysis revealed that educational background, body mass index, gestational age, pathological obstetrics, longer duration of the second stage of labor, forceps delivery or vacuum extraction, neonatal weight, neonatal sex, and meconium-stained amniotic fluid were independent risk factors for 1-min Apgar scores <7. Neonates who had low 1-min Apgar scores were more frequently admitted to the neonatology department for further observation or treatment. Early detection of risk factors and timely intervention to address these factors may improve neonatal outcomes at birth and reduce the rate of admission to the neonatology department.
Highlights
Dr Virginia Apgar created the Apgar score in 1952
Neonates were included in the study if the following criteria were met: 1) neonate mothers from 37 weeks 0 days to 41 weeks 6 days of single gestation who underwent vaginal delivery in the supine position; 2) neonate mothers with pregnancy complicated by pathological obstetrics, who met the criteria for vaginal delivery after professional assessment by obstetricians; and 3) neonate mothers who did not undergo painless delivery
A total of 1535 (14.5%) neonates were admitted to the neonatology department for further observation or treatment and all were healthy at the time of discharge
Summary
Dr Virginia Apgar created the Apgar score in 1952. Since it has been used worldwide for the rapid and standardized assessment of neonates after delivery and for the assessment of the need for prompt intervention to establish breathing at 1 min of age [1]. The Apgar score comprises the following five clinical signs: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each of these components is assessed and assigned a value of 0, 1, or 2, and the sum of these components is the final score. Even after more than half a century since the Apgar score was integrated into routine clinical practice, it remains a standardized, effective, and convenient tool for neonatal assessment [2]
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