scholarly journals The determinants of 5th minute low Apgar score among newborns who delivered at public hospitals in Hawassa City, South Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alex Yeshaneh ◽  
Andargachew Kassa ◽  
Zemenu Yohannes Kassa ◽  
Daniel Adane ◽  
Yohannes Fikadu ◽  
...  

Abstract Background Newborn morbidity and mortality are forecasted using the Apgar scores. Obstetricians worldwide have used the Apgar score for more than half a century for the assessment of immediate newborn conditions. It is a simple and convenient evaluation system that offers a standardized and effective assessment of newborn infants. Neonatal morbidity and mortality can be reduced if high-risk neonates are identified and managed adequately. This study aimed to assess the determinants of 5th minute low Apgar score among newborns at Public hospitals in Hawassa city, South Ethiopia. Methods A hospital-based unmatched case-control study was conducted at Public Hospitals in Hawassa city. Data were collected from 134 cases and 267 controls using a structured and pre-tested questionnaire by observing, interviewing, and reviewing patient cards. Newborns who delivered with a 5th minute Apgar score < 7 were considered as cases; whereas a similar group of newborns with a 5th minute Apgar score of ≥ 7 were categorized as controls. A consecutive sampling technique was employed to recruit cases, while a simple random sampling technique was used to select controls. Data entry and analysis were performed using Epi Data version 3.1 and SPSS version 20 respectively. Binary and multivariable analyses with a 95 % confidence level were performed. In the final model, variables with P < 0.05 were considered statistically significant. Results After controlling for possible confounding factors, the results showed that lack of physical and emotional support during labor and delivery [AOR = 3.5, 95 %CI:1.82–6.76], rural residence [AOR = 4, 95 %CI: 2.21–7.34], lack of antenatal care follow up [AOR = 3.5, 95 % CI: 1.91–6.33], anemia during pregnancy [AOR = 2.3,95 %CI: 1.10–4.71] and low birth weight [AOR = 6.2, 95 %CI: 2.78–14.03] were determinant factors of low Apgar scores. The area under the Apgar score ROC curve was 87.4 %. Conclusions Lack of physical and emotional support, rural residence, lack of ANC follow-up, low birth weight, and anemia during pregnancy were determinant factors of a low Apgar score. `Effective health education during preconception about anemia during pregnancy and ANC will help in detecting high-risk pregnancies that lead to a low Apgar score. In addition to the standard care of using electronic fetal monitoring, increasing access to compassion ships during labor and delivery is recommended.

Author(s):  
Tahir Ahmed Hassen ◽  
Catherine Chojenta ◽  
Nicholas Egan ◽  
Deborah Loxton

This study aimed to evaluate the association of the five-minute Apgar score and neurodevelopmental outcomes in children by taking the entire range of Apgar scores into account. Data from the Australian Longitudinal Study of Women’s Health (ALSWH) and Mothers and their Children’s Health (MatCH) study were linked with Australian state-based Perinatal Data Collections (PDCs) for 809 children aged 8−66 months old. Generalized estimating equations were used to model the association between the five-minute Apgar scores and neurodevelopmental outcomes, using STATA software V.15. Of the 809 children, 614 (75.3%) had a five-minute Apgar score of 9, and 130 (16.1%) had an Apgar score of 10. Approximately 1.9% and 6.2% had Apgar scores of 0−6 and 7−8, respectively. Sixty-nine (8.5%) of children had a neurodevelopmental delay. Children with an Apgar score of 0−6 (AOR = 5.7; 95% CI: 1.2, 27.8) and 7−8 (AOR = 4.1; 95% CI: 1.2, 14.1) had greater odds of gross-motor neurodevelopment delay compared to children with an Apgar score of 10. Further, when continuously modelled, the five-minute Apgar score was inversely associated with neurodevelopmental delay (AOR = 0.75; 95% CI: 0.60, 0.93). Five-minute Apgar score was independently and inversely associated with a neurodevelopmental delay, and the risks were higher even within an Apgar score of 7−8. Hence, the Apgar score may need to be taken into account when evaluating neurodevelopmental outcomes in children.


PEDIATRICS ◽  
1982 ◽  
Vol 69 (4) ◽  
pp. 426-431
Author(s):  
Virginia D. Black ◽  
Lula O. Lubchenco ◽  
Dennis W. Luckey ◽  
Beverly L. Koops ◽  
Gail A. McGuinness ◽  
...  

One hundred eleven consecutive infants with neonatal hyperviscosity were identified by screening all newborns for polycythemia in an 18-month period. These polycythemic infants were matched with nonpolycythemic newborns for birth weight, gestational age, Apgar scores, and sex. Maternal, intrapartum, and neonatal data were analyzed for associated morbidity. Maternal preeclampsia was more common among the hyperviscous patients than among control subjects. Hypoglycemia was also significantly increased among the hyperviscous patients. Follow-up studies at 1 to 3 years of age revealed a significantly higher incidence (38% vs 11%) of motor and neurologic abnormalities in the infants with neonatal hyperviscosity. The data suggested that concurrent hypoglycemia increased the risk of a poor outcome in hyperviscous infants inasmuch as 55% of infants with both characteristics were abnormal at follow-up. This, however, was not significantly different from the outcome of infants with hyperviscosity alone (P &gt; .05 but &lt; .1). Further studies will be needed to confirm or deny this relationship.


2019 ◽  
Author(s):  
Alemwork Desta Meshesha ◽  
Muluken Azage ◽  
Endalkachew Worku ◽  
Getahun Gebre Bogale

Abstract Background Globally, every year, 2.5 million infants die within their first month of life. Neonatal asphyxia is the leading specific cause of neonatal mortality in low- and middle-income countries, including Ethiopia. Therefore, the aim of this study was to identify the determinants of birth asphyxia among newborns admitted in Amhara region referral hospitals, Ethiopia. Methods Facility-based unmatched case-control study was employed among 193 cases and 193 controls of newborns. Newborns admitted to neonatal intensive care units with admission criteria of birth asphyxia and without birth asphyxia were considered as cases (Apgar score<7) and controls (Apgar score>=7) respectively. Data were collected using a structured questionnaire by systematic random sampling technique with proportional allocation, and entered in to Epi-Info version 7 and exported to SPSS version 20 for statistical analysis. Bivariate and multivariable logistic regression models were fitted to identify determinants of birth asphyxia. Results Newborns with low birth weight (<2.5kg) had 8.94 higher odds of birth asphyxia than those whose weight at birth was >=2.5kg at birth (AOR: 8.94, 95% CI: 4.08, 19.56). Newborns born at health centers were 7.36 times more likely to develop birth asphyxia than those born at hospitals (AOR: 7.36, 95% CI: 2.44, 22.13). Newborns born using instrumental delivery were 3.03 times more likely to develop birth asphyxia than those delivered by vaginally (AOR: 3.03, 95% CI: 1.41, 6.49). Newborns from mothers with prolonged labor were 2 times more likely to suffer from birth asphyxia as compared to their counterparts (AOR: 2.00, 95% CI: 1.20, 3.36). Conclusion This study identified prolonged labor, instrumental delivery, delivered at health centers, and low birth weight were identified as determinants of birth asphyxia. Thus, intervention planning towards the identified determinants may be needed to reduce neonatal birth asphyxia.


2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Sielu Alemayehu Desta ◽  
Ashenafi Damte ◽  
Tsehay Hailu

Abstract Background Mothers in low socio-economic conditions frequently have low birth weight infants. Inaddition Physically demanding work during pregnancy also contributes to poor fetal growth. During gestation a woman needs balanced nutrition for a healthy outcome. Women with inadequate nutritional status at conception are at greater risk of aquiring disease; their health usually depends on the availability and consumption of balanced diet, and therefore they are unlikely to be able to resist with their high nutrient needs during pregnancy. Therefore, the main purpose of this study was to assess the maternal risk factors associated low birth weight in public hospitals of Mekelle city, Tigray North Ethiopia, 2017/2018. Methods Un-matched case-control study design was conducted among women who delivered in public hospitals of Mekelle city. Data was collected using a structured questionnaire through interview, direct physical assessment and medical record review of mothers. Sample size was calculated by Epi-info version 7.0 to get a final sample size of 381(cases = 127 and controls = 254). SPSS version 20 was used for analysis. Bivariate and multivariate logistic regression analysis was used to determine the effect of the independent variables on birth weight. Presence of significant association was determined using OR with its 95%CI. A P value of less than 0.05 was considered to declare statistical significance. Table, graphs and texts were used to present the data. Result Most of the mothers (70.1% cases and 43.7% controls) were housewives. This study showed that maternal age ≤ 20 years (AOR = 6.42(95% CI = (1.93–21.42)), ANC follow up (AOR = 3.73(95%CI (1.5–9.24)), History of medical illness (AOR = 14.56(95% CI (3.69–57.45), Iron folate intake (AOR = 21.56(95%CI (6.54–71.14)), Maternal height less than 150 cm (AOR = 9.27(95%CI 3.45–24.89)) and Pregnancy weight gain (AOR = 4.93(95%CI = 1.8–13.48) were significant predictors of low birth weight. Conclusion The study suggests that inadequate ANC follow-up, preterm birth and history of chronic medical illness, maternal height, pregnancy weight gain, and Iron intake were. Were significant predictors of low birth weight. Health professionals should screen and consulate pregnant mothers who are at risk of having infants with LBW and ensure that women have access to essential health information on the causes of low birth weight.


2020 ◽  
Author(s):  
Alhassan Sibdow Abukari ◽  
Shamsudeen Mohammed ◽  
Nathaniel Awuni ◽  
Ibrahim Yakubu ◽  
Adam Yakubu ◽  
...  

Abstract Background: Apgar score remains the most effective measure of newborn health outcomes in the first few minutes of delivery and it is useful in diagnosing perinatal asphyxia and metabolic acidosis. Methods: This retrospective cross-sectional study was conducted at the Baptist Medical Centre in the North East Region of Ghana. For the period January 1 to December 31 2018, we extracted information on 3011 women who delivered at the facility from birth records. Binary logistic regression models were used to determine the factors associated with low fifth minute Apgar score, preterm low fifth minute Apgar score, and term low fifth minute Apgar score.Results :Nearly half of the participants had experienced 2 to 5 pregnancies (47.1%) and had given birth to 2 to 5 children (47.7%). Most of the women delivered at 37 weeks gestation or more (87.6%), attended 1 to 4 antenatal care visits (53.2%), and received 1 to 3 doses of sulfadoxine-pyrimethamine (70.9%). The majority of the newborns weighed 2.5kg or more at birth (90.7%), were delivered through the vagina (79.8%), and a little over half of them (51.40%) were males. After adjusting for potential confounders, we found evidence that multigravid women were 0.67 (95% CI 0.49 - 0.90) times less likely to deliver a child with low fifth minute Apgar score while delivery at less than 37 weeks gestation, birth weight of less than 2.5kg, and caesarean delivery were associated with increased odds of low fifth minute Apgar score. For infants born at term, being born to a multigravid mother was protective against low fifth minute Apgar score while delivery through caesarean section increased the odds of low fifth minute Apgar score among this group of newborns. Among preterm infants, our study found strong evidence that those born with low birth weight (<2.5kg) had about 4 times the odds of suffering low fifth minute Apgar score compared to those with normal birth weight.Conclusion:In designing interventions to improve the survival and the Apgar score of newborns, measures to properly diagnose and prevent preterm delivery and low birth weight should be of great concern.


Author(s):  
Martha G. Fuller ◽  
Tianyao Lu ◽  
Erika E. Gray ◽  
Maria A. L. Jocson ◽  
Mary K. Barger ◽  
...  

Objective This study was aimed to determine factors associated with attendance at the second high-risk infant follow-up (HRIF) visit (V2) by 20 months of corrected age after a successful first visit (V1), and the impact of rural residence on attendance rates in a statewide population of very low birth weight (VLBW; <1,500 g) infants. Study Design Data linked from the California Perinatal Quality of Care Collaborative (CPQCC) Neonatal Intensive Care Unit (NICU) database and CPQCC-California Children's Services (CCS) HRIF database. Multivariable logistic regression evaluated independent associations of sociodemographic, maternal, family, neonatal clinical, and individual HRIF program differences (factors) with successful V2 in VLBW infants born in 2010 to 2012. Results Of 7,295 eligible VLBW infants, 75% (5,475) attended V2. Sociodemographic factors independently associated with nonattendance included maternal race of Black (adjusted odds ratio [aOR] = 0.61; 95% confidence interval [CI]: 0.5–0.75), public insurance (aOR = 0.79; 95% CI: 0.69–0.91), and rural residence (aOR = 0.74; 95% CI: 0.61–0.9). Factors identified at V1that were associated with V2 attendance included attending V1 within the recommended window (aOR = 2.34; 95% CI: 1.99–2.75) and early intervention enrollment (aOR = 1.39; 95% CI: 1.12–1.61). Neonatal factors associated with attendance included birth weight ≤750 g (aOR = 1.83; 95% CI: 1.48–2.5). There were significant program differences with risk-adjusted rates ranging from 43.7 to 99.7%. Conclusion Sociodemographic disparities and HRIF program factors are associated with decreased attendance at V2 among VLBW infants. These findings highlight opportunities for quality and process improvement interventions starting in the NICU and continuing through transition to home and community to assure participation in HRIF. Key Points


Author(s):  
Helen Trotman ◽  
Maureen Samms-Vaughan ◽  
Charlene Coore-Desai ◽  
Jody-Ann Reece ◽  
Oluwayomi Olugbuyi

Objective The study aimed to determine the outcome of babies born to women ≥40 years in a Jamaican birth cohort. Patients and Methods Maternal demographic data and neonatal data for women ≥40 years who delivered live singleton babies and their younger counterparts aged 20 30 years were extracted from the JA KIDS birth cohort dataset. Outcome measures were preterm birth, low birth weight, very low birth weight, extremely low birth weight, macrosomia, a low 5-minute Apgar score <7, admission to the neonatal unit, and neonatal death. Descriptive analyses were performed; statistical significance was taken at the level p <0.05. Results A total of 5,424 women and their babies were entered into the study, 5,099 (94%) women were aged 20 to 30 years (mean age ± standard deviation [SD]: 24.5 ± 3.2 years) and 325 (6%) were aged ≥40 years (mean age ± SD: 41.5 ± 1.6 years). A greater percentage of preterm babies (18%) were born to women ≥40 years than to their younger counterparts (14%; p = 0.04). There was no difference in the proportion of low birth weight infants, very low birth weight infants, or extremely low birth weight infants born between the two groups (p > 0.05). There was also no significant difference in the proportion of babies who were macrosomic and in those who had a low 5-minute Apgar score <7. There were 866 (16%) neonatal admissions, 67/325 (21%) of these babies were born to women aged ≥40 years and 799/5,099 (16%) were born to their younger counterparts (p = 0.01). The commonest reason for admission was prematurity. While 60 babies died, there was no significant difference between both groups with 56 (1%) born to women 20 to 30 years and 4 (1%) born to women ≥40 years (p = 0.48). Conclusion Adverse outcomes noted for babies born to women ≥40 years were prematurity and the need for neonatal admission. However, no excess mortality was recorded. Key Points


2016 ◽  
Vol 51 (4) ◽  
pp. 272
Author(s):  
Warih Angesti P ◽  
Ernawati Ernawati ◽  
Dwi Susanti

Hemolysis, elevated liver enzyme, and low platelet count syndrome (HELLPs) is complication following severe preeclampsia which is one of the three leading causes of maternal mortality in Indonesia. The purpose of this study was to understand the prevalence, characteristics, and post-partum outcome of HELLPs patients who deliver in Dr. Soetomo Hospital in July 2012-June 2013. This study was observational-descriptive, cross sectional study. The population observed was the severe preeclampsia patients who deliver in Dr. Soetomo Hospital and have complete medical data in July 2012-June 2013. study subject taken by total sampling. HELLPs follow the 7% of severe preeclampsia patients. The maternal average age of HELLPs group was 30.2 (19-43), while in non-HELLPs was 30.8 (17-46). Most HELLPs patients were in the first and second pregnancy. The average of gestational age at labor in HELLPs was 33-34 weeks. Both in HELLPs and non-HELLPs most performed Cesarean Section delivery. No post-partum maternal mortality found in HELLPs, but 25% had stillbirth. The average of birth weight in HELLPs was 1994.4 g. First minute Apgar score >7 was 33.3% in HELLPs group. In conclusion, Most HELLPs patients were in the first and second pregnancy, while non-HELLPs were in first pregnancy. The average of gestational age at labor was lower in HELLPs group. Neonates mortality were higher in HELLPs group. The average of birth weight was lower in HELLPs group. First minute Apgar score > 7 was higher in non-HELLP group.


2019 ◽  
Vol 1 (2) ◽  
pp. 42
Author(s):  
Ahimsa Yoga Anindita ◽  
Dwi Hidayah ◽  
Yulidar Hafidh ◽  
Annang Giri Moelyo ◽  
Mayasari Dewi

<p class="TextAbstract"><strong>Introduction</strong>: The presence of meconium in amniotic fluid occurs in 13% of live births in developing countries. This condition develops when the gestational age increases at delivery. Meconium aspiration syndrome occurs in 5% of newborns in meconium stained amniotic fluid. The aim of this study is to determine the profile of newborns who experience meconium aspiration syndrome (MAS) who are treated at Dr. Soetrasno Hospital, Rembang and its outcome.</p><p class="TextAbstract"><strong>Methods</strong>: Prospective study, data were obtained from medical records of Dr. Soetrasno Hospital, Rembang during September to October 2018, on newborns with MAS.</p><p class="TextAbstract"><strong>Results</strong>: Of 12 newborns with MAS were obtained, consisting of 7 (58.3%) male and 5 (41.7%) female. All cases were term infants (gestational age above 37 weeks) and normal birth weight (above 2500 grams). Based on the first minute APGAR score, there were 4 newborns had score 1 and 2, respectively (33.3%). Based on the fifth minute APGAR score, there were 7 newborns had score 3 (58.3%). The outcome of newborns with MAS were 7 alive (58.3%) and 5 died (41.7%).</p><p class="TextAbstract"><strong>Conclusion</strong>: There were 12 newborns suffering from MAS (54.5%) of 22 babies hospitalized at the NICU dr. Soetrasno Hospital Rembang. All newborns with MAS were term infants and normal birth weight. There were 5 newborns with MAS which required invasive mechanical ventilation (intubation) and all died (41.7%).</p><p class="Keywords"> </p>


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