Abstract
Background: Cord blood biochemical parameter reflects the status of neonate. APGAR score following birth is used for evaluation of the neonate. There is limited data regarding the correlation between APGAR score and cord blood sugar levels.Subjects and Methods:Glucose Oxidase Peroxidase method was used for measuring cord blood sugar levels of 250 randomly selected consecutive samples. At 1 minute and 5 minutes of life the APGAR scores of the newborns were assessed by a single person in order to avoid subjective variability. The collected data was analyzed using the SPSS software. Mothers with gestational diabetes mellitus and overt diabetes were excluded from the study. Result:The mean age of the mothers in the study population was 22.86 years ± 3.465(SD). The mean blood glucose level in the maternal blood was 88.16 mg/dl ± 10.675(SD). The vaginal deliveries were 60.6% and Lower Uterine Caesarean Sections were 39.4 %. The cord blood glucose level had a mean value of 92.48 mg/dl ±21.005 (SD). The mean APGAR scores after 1 minute and 5 minutes of birth were found to be 4.82 ± 1.42(SD) and 7.01 ±1.68 (SD) respectively. Conclusion:The study showed no correlation with cord blood sugar levels and APGAR scores calculated at 1 minute and 5 minutes of life. The study found that neonates were free from complications if the cord blood sugar levels were around 87 mg/dl.
Highlights
Labor is a stressful situation to both the mother and fetus
Our study concludes that with proper and timely interventions the 97% of the neonates with APGAR scores of less than 7 at one minute reduced to 32% at five minutes of life
There was no correlation between the APGAR scores at one and five minutes of life with the cord blood sugar levels
Summary
Labor is a stressful situation to both the mother and fetus. During labor the presence of fatigue, pain, physiologic alterations and the maternal anxiety, stresses the mother and increases the maternal catecholamines. The production of catecholamines is comparatively higher during the normal vaginal delivery than during cesarean section, this can be explained by the increased stress in vaginal delivery This labor induced fetal catecholamine surge is presumed to provide the neonate with an important mechanism of adaptation to the extra-uterine environment. Newborns delivered via normal vaginal delivery have increased level of blood glucose than their counterparts delivered through elective cesarean section because of increased catecholamines release. If the neonates fail to achieve normoglycemia and diagnosis is missed, it may become symptomatic and can suffer long term complications due to cerebral injury.[2] In 1952, Virginia APGAR proposed the APGAR score for evaluating the physical condition of newborns shortly after delivery. Conclusion: The study showed no correlation with cord blood sugar levels and APGAR scores calculated at 1 minute and 5 minutes of life. The study found that neonates were free from complications if the cord blood sugar levels were around 87 mg/dl
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