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急诊剖宫产分娩母亲中第5分钟阿氏评分低的患病率及相关因素:埃塞俄比亚的前瞻性横断面研究

Prevalence and factors associated with low 5th minute APGAR score among mothers who birth through emergency cesarean section: prospective cross-sectional study in Ethiopia.

作者信息

Tantu Temesgen, Tantu Tayech, Hailu Yohanna, Gashaw Dereje, Melkamu Biruk

机构信息

Obstetrics and gynecology in Wolkite University College of medicine and health sciences, Wolkite, Ethiopia.

Department of obstetrics and gynecology, University of Rwanda, Kigali, Rwanda.

出版信息

BMC Pregnancy Childbirth. 2025 Mar 25;25(1):342. doi: 10.1186/s12884-025-07456-9.

Abstract

BACKGROUND

Apgar score is a method to assess the status of the baby immediately after delivery. It also used to assess the response to and overall the prognosis of the resuscitations. In Ethiopia Birth asphyxia is the one leading cause of neonatal mortality and morbidity. The APGAR score especially the 5th minute one has strong prediction of the neonatal outcome than the 1st minute APGAR score so this study focuses on identifying the prevalence and factors associated with of 5th minute APGAR score among mothers who gave birth through cesarean section in Wolkite University specialized hospital in January to June 2023 G.C.

METHODS

Institution based prospective cross-sectional study was conducted by using convenience sampling on 270 Mothers, who gave birth through cesarean section in Wolkite University specialized hospital from January 1- June 30 2023 GC. The data collection was conducted through meticulous chart review and interviews. Data were entered using Epi data 7 and analyzed with SPSS 26. The association between independent variables and the 5th minute APGAR was estimated using an odds ratio with 95% confidence intervals. The statistical significance of the association was declared at P-value < 0.05.

RESULTS

Total of 270 mothers were included and the prevalence of low fifth minute APGAR score 27.4%. multivariate logistic regression analysis showed that the predictors of low 5th minute APGAR score are fetal heart beat before intervention( bradycardia ( AOR = 9.1; 95% CI: 3.8,21.9),tachycardia ( AOR = 3.7; 95% CI: 1.5,9.8)), meconium stained Amniotic fluid (AOR = 3.0; 95% CI: 1.5,6.2), labor duration greater than 24 h ( AOR = 11.2; 95% CI: 3.9, 31.9), low birth weight( AOR = 4.3; 95% CI: 1.7,10.3).

CONCLUSION

A low APGAR score is highly prevalent. Fetal heart beat before intervention, meconium stained Amniotic fluid, labor duration greater than 24 h, low birth weight are statistically significant predictors of poor APGAR. Enhancing the early obstetric interventions like electronic fetal monitoring, use of partograph, and timely cesarean sections as well as early neonatal resuscitation techniques might mitigate the risk of complications linked with low APGAR scores.

摘要

背景

阿氏评分是一种在婴儿出生后立即评估其状况的方法。它也用于评估复苏的反应及总体预后。在埃塞俄比亚,出生窒息是新生儿死亡和发病的主要原因之一。阿氏评分,尤其是第5分钟的评分,比第1分钟的阿氏评分对新生儿结局有更强的预测性,因此本研究聚焦于确定2023年埃塞俄比亚历1月至6月在沃尔凯特大学专科医院剖宫产的母亲中第5分钟阿氏评分的患病率及相关因素。

方法

采用便利抽样法,对2023年埃塞俄比亚历1月1日至6月30日在沃尔凯特大学专科医院剖宫产的270名母亲进行基于机构的前瞻性横断面研究。通过仔细查阅病历和访谈收集数据。数据使用Epi data 7录入,并采用SPSS 26进行分析。使用比值比及95%置信区间估计自变量与第5分钟阿氏评分之间的关联。当P值<0.05时,宣布关联具有统计学意义。

结果

共纳入270名母亲,第5分钟阿氏评分低的患病率为27.4%。多因素逻辑回归分析显示,第5分钟阿氏评分低的预测因素包括干预前胎心(心动过缓(比值比=9.1;95%置信区间:3.8,21.9),心动过速(比值比=3.7;95%置信区间:1.5,9.8))、羊水胎粪污染(比值比=3.0;95%置信区间:1.5,6.2)、产程大于24小时(比值比=11.2;95%置信区间:3.9,31.9)、低出生体重(比值比=4.3;95%置信区间:1.7,10.3)。

结论

低阿氏评分非常普遍。干预前胎心、羊水胎粪污染、产程大于24小时、低出生体重是阿氏评分低的统计学显著预测因素。加强早期产科干预,如电子胎心监护、使用产程图、及时剖宫产以及早期新生儿复苏技术,可能会降低与低阿氏评分相关的并发症风险。

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