Department of Anesthesia, College of Medicine and Health Sciences, Wachemo University, Hosaina, Ethiopia.
School of Public Health, College of Medicine & Health Sciences, Wachemo University, Hosaina, Ethiopia.
Sci Rep. 2024 May 30;14(1):12420. doi: 10.1038/s41598-024-62223-8.
A variety of factors can predispose newborns to have a low Apgar score after delivery. Identification of the determinants of low Apgar scores is an important first step to take to apply the necessary precautions. This study aimed to identify the determinants of low fifth-minute Apgar score after a Cesarean section. An institutional-based case-control study was conducted among mothers who deliver their newborns by Cesarean section in Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Ethiopia, from July 1, 2022, to September 30, 2022. Data were collected from 70 cases and 140 controls using a semi-structured checklist. A systematic random sampling technique was used to select both charts of mothers with cases and controls. Charts of mothers with newborns Apgar score less than 7 were considered as cases; whereas a similar group of charts of mothers with newborns with fifth-minute Apgar score greater than or equal to 7 were categorized as control. Descriptive statistics and bivariable and multivariable binary logistic regression analyses were conducted to describe the mothers and newborns and identify determinants of the fifth-minute low Apgar score, respectively. Adjusted odds ratios (AOR) with their respective 95% confidence interval (CI) were used to declare the determinant factors, and the statistical significance was set at P < 0.05. In total, 140 controls and 70 cases of mothers charts were enrolled in this study. The Mean ± SD age of mothers of cases and controls were 26.9 ± 4.9 and 27.06 ± 4.1 years, respectively. General anaesthesia (AOR = 4.2; 95% CI: 1.9 ‒ 9.3), rural residence (AOR = 3.7, 95% CI, 1.7‒8.1), low birth weight (AOR = 3.2, 95% CI, 1.3‒7.8), and emergency Cesarean section (AOR = 2.6; 95% CI: 1.2 ‒ 5.8) were identified determinant factors of low fifth minute Apgar score. A fifth-minute low Apgar score was significantly associated with newborns delivered through emergency Cesarean section, low birth weight, rural residence, and delivered from mothers who had undergone Cesarean section under general anaesthesia.
多种因素可导致新生儿在分娩后 Apgar 评分较低。确定 Apgar 评分较低的决定因素是采取必要预防措施的重要第一步。本研究旨在确定剖宫产术后第五分钟 Apgar 评分较低的决定因素。2022 年 7 月 1 日至 9 月 30 日，在埃塞俄比亚 Nigist Eleni Mohammed Memorial 综合专科医院，对通过剖宫产分娩的母亲进行了一项基于机构的病例对照研究。使用半结构化清单从 70 例病例和 140 例对照中收集数据。使用系统随机抽样技术选择病例和对照的母亲图表。新生儿 Apgar 评分低于 7 的母亲图表被视为病例；而类似的一组新生儿 Apgar 评分在第五分钟大于或等于 7 的母亲图表被归类为对照组。进行描述性统计和单变量及多变量二元逻辑回归分析，分别描述母亲和新生儿的情况，并确定第五分钟 Apgar 评分较低的决定因素。使用调整后的优势比 (AOR) 及其相应的 95%置信区间 (CI) 来宣布决定因素，统计显著性设置为 P < 0.05。本研究共纳入 140 名对照和 70 名病例的母亲图表。病例和对照组母亲的平均年龄分别为 26.9 ± 4.9 岁和 27.06 ± 4.1 岁。全身麻醉（AOR=4.2；95%CI：1.9-9.3）、农村居住（AOR=3.7，95%CI，1.7-8.1）、低出生体重（AOR=3.2，95%CI，1.3-7.8）和紧急剖宫产（AOR=2.6；95%CI：1.2-5.8）是第五分钟 Apgar 评分较低的决定因素。新生儿通过紧急剖宫产、低出生体重、农村居住和全身麻醉下接受剖宫产的母亲分娩与第五分钟 Apgar 评分较低显著相关。
