Svenvik Maria, Brudin Lars, Blomberg Marie
Department of Obstetrics and Gynecology, Kalmar County Hospital, 391 85 Kalmar, Sweden.
Department of Clinical Physiology, Kalmar County Hospital, 391 85 Kalmar, Sweden ; Department of Medicine and Health Sciences, Linköping University Hospital, 581 85 Linköping, Sweden.
Biomed Res Int. 2015;2015:978079. doi: 10.1155/2015/978079. Epub 2015 Aug 27.
To determine predictive risk factors for Apgar scores < 7 at 5 minutes at two hospitals providing tertiary care and secondary care, respectively.
A retrospective registry cohort study of 21126 births (2006-2010) using data from digital medical records. Risk factors were analyzed by logistic regression analyses.
AS(5 min) < 7 was multivariately associated with the following: preterm birth; gestational week 32 + 0-36 + 6, OR = 3.9 (95% CI 2.9-5.3); week 28 + 0-31 + 6, OR = 8 (5-12); week < 28 + 0, OR = 15 (8-29); postterm birth, OR = 2.0 (1.7-2.3); multiple pregnancy, OR = 3.53 (1.79-6.96); previous cesarean section, OR = 3.67 (2.31-5.81); BMI 25-29, OR = 1.30 (1.09-1.55); BMI ≥ 30 OR = 1.70 (1.20-2.41); nonnormal CTG at admission, OR = 1.98 (1.48-2.66). ≥ 1-para was associated with a decreased risk for AS(5 min) < 7, OR = 0.34 (0.25-0.47). In the univariate logistic regression analysis AS(5 min) < 7 was associated with tertiary level care, OR = 1.48 (1.17-1.87); however, in the multivariate analysis there was no significant difference.
A number of partially preventable risk factors were identified, preterm birth being the most evident. Further, no significant difference between the two hospital levels regarding the risk for low Apgar scores was detected.
分别在一家提供三级护理和一家提供二级护理的医院，确定出生后5分钟阿氏评分<7分的预测风险因素。
一项回顾性登记队列研究，利用数字病历数据对21126例分娩（2006 - 2010年）进行分析。通过逻辑回归分析对风险因素进行分析。
5分钟阿氏评分<7分与以下因素多变量相关：早产；孕32 + 0 - 36 + 6周，比值比（OR）= 3.9（95%置信区间[CI] 2.9 - 5.3）；孕28 + 0 - 31 + 6周，OR = 8（5 - 12）；孕<28 + 0周，OR = 15（8 - 29）；过期产，OR = 2.0（1.7 - 2.3）；多胎妊娠，OR = 3.53（1.79 - 6.96）；既往剖宫产史，OR = 3.67（2.31 - 5.81）；体重指数（BMI）25 - 29，OR = 1.30（1.09 - 1.55）；BMI≥30，OR = 1.70（1.20 - 2.41）；入院时产时胎心监护异常，OR = 1.98（1.48 - 2.66）。≥1次经产与5分钟阿氏评分<7分的风险降低相关，OR = 0.34（0.25 - 0.47）。在单变量逻辑回归分析中，5分钟阿氏评分<7分与三级护理相关，OR = 1.48（1.17 - 1.87）；然而，在多变量分析中无显著差异。
确定了一些部分可预防的风险因素，早产最为明显。此外，未检测到两家医院级别在低阿氏评分风险方面的显著差异。
