足月（近足月）单胎中低 5 分钟 Apgar 评分呈上升趋势：一项荷兰全国队列研究。
Increasing trends in a low 5-min Apgar score among (near) term singletons: a Dutch nationwide cohort study.
机构信息
Department of Neonatology, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands.
出版信息
J Perinatol. 2024 Feb;44(2):217-223. doi: 10.1038/s41372-023-01786-2. Epub 2023 Oct 18.
OBJECTIVE
To investigate trends in low Apgar scores in (near) term singletons using the Dutch Perinatal Registry.
METHODS
In a cohort of 1,583,188 singletons liveborn ≥35 weeks of gestation in the period 2010-2019, we studied trends in low 5-min Apgar scores (<7 and <4) using Cochrane Armitage trend tests.
RESULTS
The proportion of infants with low Apgar scores <7 and <4 increased significantly between 2010-2019 (1.04-1.42% (p < 0.001), 0.17-0.19% (p = 0.009), respectively). Neonatal mortality remained unchanged. Induction of labour, epidural analgesia and planned caesarean section showed an increasing trend. Instrumental vaginal delivery and emergency caesarean section were performed less frequently over time, but these intervention subgroups showed the highest relative increase in infants with low Apgar scores.
CONCLUSIONS
In the Netherlands, the risk of a low 5-min Apgar score increased over the last decade. The highest relative increase was observed in subgroups of instrumental vaginal delivery and emergency caesarean section.
目的
利用荷兰围产儿登记处研究足月（近足月）单胎儿低 Apgar 评分的趋势。
方法
在 2010 年至 2019 年间，我们对 1583188 例≥35 孕周足月单胎活产儿进行了研究，使用 Cochrane-Armitage 趋势检验研究低 5 分钟 Apgar 评分（<7 分和<4 分）的趋势。
结果
2010 年至 2019 年间，低 Apgar 评分<7 分和<4 分的婴儿比例显著增加（分别为 1.04-1.42%（p<0.001）和 0.17-0.19%（p=0.009））。新生儿死亡率保持不变。引产、硬膜外镇痛和计划性剖宫产呈上升趋势。经阴道器械分娩和急诊剖宫产的比例随时间推移呈下降趋势，但这些干预亚组的低 Apgar 评分婴儿的相对增加幅度最高。
结论
在荷兰，过去十年中，低 5 分钟 Apgar 评分的风险增加。经阴道器械分娩和急诊剖宫产的亚组中，相对增加幅度最大。
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