Abstract
Objective
To evaluate the specific maternal and perinatal variables associated with a low (≤3)
or moderate (4–6) Apgar score, compared to a high (≥7) score.
Study design
This was a retrospective, cohort study of 58429 term singleton babies born at the
Mater Mother’s Hospital in Brisbane, Australia in 2007–2013. Maternal demographics,
socio-economic status using the Australian Socioeconomic Index for Areas (SEIFA) score,
obstetric factors, and birth outcomes were compared for neonates grouped into three
categories based on their five-minute Apgar: low (≤3), moderate (4–6) and high (≥7).
The low- and moderate-score cohorts were individually compared to the high-score cohort
using both univariate and multivariate analysis.
Results
Logistic regression analysis confirmed that of the variables analysed, only maternal
public insurance status (OR 2.1, 95% CI 1.5–3.1), breech presentation (OR 2.4, 95%
CI 1.1–4.6), other non-cephalic presentation (OR 9.5, 95% CI 2.2–25.4), intramuscular
narcotic use (OR 2.3, 95% CI 1.5–3.5), and presence of meconium (OR 3.7, 95% CI 2.5–5.4)
were significantly associated with low Apgar scores. Variables significantly associated
with a moderate score were: SEIFA ≤50th centile (OR 1.6, 95% CI 1.2–2.0) and 61st
to 70th centile (OR 1.31, 95% CI 0.9–1.8) categories, maternal public insurance status
(OR 2.7, 95% CI 2.2–3.3), nulliparity (OR 2.0, 95% CI 1.7–2.5), emergency caesarean
birth (OR 2.6, 95% CI 2.1–3.2), instrumental birth (OR 2.3, 95% CI 1.9–2.9), and presence
of meconium (OR 2.6, 95% CI 2.1–3.2).
Conclusions
Factors associated with low and moderate Apgar scores vary in type and degree of influence.
Distinctions in the perinatal background can help predict newborn compromise and accelerate
delivery of care.
Keywords
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Article info
Publication history
Published online: January 06, 2017
Accepted:
January 4,
2017
Received in revised form:
December 23,
2016
Received:
June 14,
2016
Identification
Copyright
© 2017 Published by Elsevier Ireland Ltd.
