Apgar Scoring System in Brazil's Live Births Records: Differences between Home and Hospital Births

Abstract

Objective To promote informed choice for women and to compare home and hospital births in relation to the Apgar score. Methods Mother's profile and Apgar score of naturally born infants (without forceps assistance) in Brazil between 2011 and 2015, in both settings—hospital or home—were collected from live birth records provided by the Informatics Department of the Unified Health System (DATASUS, in the Portuguese acronym). For the analysis, were included only data from low-risk deliveries, including gestational time between 37 and 41 weeks, singleton pregnancy, at least four visits of prenatal care, infants weighing between 2,500 g, and 4,000 g, mother age between 20-40 years old, and absence of congenital anomalies. Results Home birth infants presented significantly higher risk of 0-5 Apgar scores, both in 1 minute (6.4% versus 3%, odds ratio [OR] = 2.2, confidence interval [CI] IC 2–2.4) and in 5 minutes (4.8% versus 0.4%, OR = 11.5, CI 10.5–12.7). Another finding is related to recovery estimates when from an initially bad 1-minute Apgar (< 6) to a subsequently better 5-minute Apgar (> 6). In this scenario, home infants had poorer recovery, Apgar score was persistently < 6 throughout the fifth minute in most cases (71% versus 10.7%, OR 20.4, CI 17–24.6). Conclusion The results show worse Apgar scores for babies born at home, compared with those born at the hospital setting. This is a pioneer and preliminary study that brings attention concerning differences in Apgar score related to home versus hospital place of birth in Brazil.

Profile of Pregnant Women who Underwent Cesarean Section and their Perinatal Outcome at a Tertiary Referral Hospital

“…However, the study in Brazil only included data from low risk births, with gestational times between 37 and 41 weeks, babies weighing 2,500-4,000 grams, maternal ages between 20-40 years, and the absence of congenital anomalies. 12 Similar to our study, in Ethiopia also obtained a distribution of 88.5% for newborns with an APGAR score of more than 7. 13 The study also found that 12% of babies must be treated in the NICU room and 40.3% treated in SCN (level 2 perinatology).…”

Monitoring combination of intermittent auscultation and palpation of contractions on oxygen saturation of newborns

“…After birth, it is important to assess the APGAR score to see if there are complications that occur in the newborn (Thavarajah et al, 2018). The APGAR assessment is also a common examination method for newborns (Bessa & Bonatto, 2019). In addition, monitoring oxygen saturation in newborns is also very important to do, by measuring oxygen saturation levels in newborns we can easily detect early bad things that might happen to children in their growth period and more quickly find out the occurrence of abnormalities.…”