背景:Apgar评分用于评估新生儿的总体状况和复苏反应,以及它在新生儿期之后的预后。低的第5分钟Apgar评分更为频繁,并且与新生儿死亡率和发病率的风险显着增加有关。在埃塞俄比亚,出生窒息的患病率很高(22.52%)。出生窒息导致新生儿严重缺氧缺血性多器官损害,主要是脑损伤。因此,本研究旨在确定剖宫产分娩新生儿中5分钟Apgar评分低的决定因素.
方法:进行了无匹配的病例对照研究设计。阿普加评分是基于心率的测量,呼吸努力,肤色,肌肉张力,和反射性烦躁。数据收集工具或检查表改编自先前在亚的斯亚贝巴进行的研究,埃塞俄比亚。在这项研究中,病例均为Apgar评分<7的新生儿,而对照组均为Apgar评分>=7的新生儿。通过简单随机抽样技术选择研究参与者。数据进入Epidata版本4.6并导出到SPSS软件版本24。采用多变量logistic回归分析各因素在P<0.05时的独立作用。
结果:与低Apgar评分相关的因素是胎儿出生体重<2.5kg[调整后的比值比(AOR)=8.17,95%置信区间(CI):1.03-64.59]P=0.046,皮肤切口至分娩时间(AOR=5.27;95-CI:2.20-12.60)P=0.001,妊娠高血压(AOR=4.58%,95%
结论:胎儿出生体重<2.5公斤,皮肤切口到分娩时间,妊娠高血压,产前出血,麻醉类型,羊水粪染和剖宫产类型是Apgar评分的独立相关因素。因此,重要的是要研究已确定的风险因素,以减少成年早期第5分钟Apgar评分较低的影响。.
BACKGROUND: Apgar score is used to evaluate the neonates\' overall status and response to resuscitation, as well as its prognosis beyond the neonatal period. Low fifth minute Apgar scores is more frequent and is associated with markedly increased risks of neonatal mortality and morbidity. In Ethiopia, the prevalence of birth asphyxia is high (22.52%). Birth asphyxia contributes to significant neonatal morbidities and mortalities due to severe hypoxic-ischemic multi-organ damage, mainly brain damage. Therefore, this study was aimed to identify determinants of low fifth minute Apgar score among newborns delivered by cesarean section.
METHODS: An unmatched case control study design was conducted. The Apgar score is based on measures of heart rate, respiratory effort, skin color, muscle tone, and reflex irritability. The data collection tool or checklist was adapted from previous study done at Addis Ababa, Ethiopia. In this study, cases were all newborns with Apgar score < 7 whereas controls were all newborns with Apgar score > = 7. The study participants were selected by simple random sampling technique. Data was into Epidata version 4.6 and exported to SPSS software version 24. Multivariable logistic regression was used to identify the independent effect of different factors at P < 0.05.
RESULTS: Factors associated with low Apgar score were fetal birth weight < 2.5 kg [adjusted odds ratio (AOR) = 8.17, 95% confidence interval (CI): 1.03 ‒ 64.59] P = 0.046, skin incision to delivery time (AOR = 5.27; 95% CI: 2.20 ‒ 12.60) P = 0.001, pregnancy induced hypertension (AOR = 4.58, 95% CI: 1.75 ‒ 11.92) P = 0.002, antepartum hemorrhage (AOR = 3.96; 95% CI: 1.75 ‒ 8.94) 0.001, general anesthesia (AOR = 3.37, 95% CI: 1.72 ‒ 6.62) P = 0.001, meconium stained amniotic fluid (AOR = 3.07, 95% CI: 1.32 ‒ 7.12) P = 0.009 and emergency cesarean section (AOR = 2.17, 95% CI: 1.13 ‒ 4.15) P = 0.019.
CONCLUSIONS: Fetal birth weight < 2.5 kg, skin incision to delivery time, pregnancy induced hypertension, antepartum hemorrhage, type of anesthesia, meconium stained amniotic fluid and type of cesarean section were factors independently associated with Apgar score. Therefore, it is important to work on identified risk factors to reduce the impacts low fifth minute Apgar score in the in early adulthood..