Determinants of low APGAR score among preeclamptic deliveries in Cipto Mangunkusumo Hospital: a retrospective cohort study in 2014

Abstract

Background: Preeclampsia has great implication on adverse neonatal outcome. Appearance, pulse, grimace, activity, respiration (APGAR) score at 1 or 5 minutes is one of the indicators of physiologic maturity of the infant. Therefore, the aim of this study was to know the correlation of APGAR score in preeclamptic deliveries with its risk factors. Methods: This study was a retrospective cohort. Data were collected from January to December 2013 including all preeclamptic women with singleton live pregnancies who delivered their babies in Cipto Mangunkusumo Hospital, Jakarta. The primary outcome was APGAR score. There were some determinants conducted in this study. Binary logistic was used as multivariate analysis to analyze the correlation between APGAR score and risk factors of preeclampsia, data were analyzed using chi square test. Results: Out of 450 preeclamptic women, 446 of them met the inclusion criteria. Low APGAR scores at 1 and 5 minutes were found in 19% (86/446) and 5.4% (24/446) of neonates respectively. Early onset of preeclampsia (adjusted OR = 4.577; 95% CI = 2.147 - 9.757), white blood cell ≥ 15,000/μL (adjusted OR = 3.315; 95% CI = 1.738 – 6.324), HELLP syndrome (adjusted OR = 2.00; 95% CI = 1.38 – 2.91) were independent risk factors for having infant with low APGAR score at 1 minute. Meanwhile, there was no significant risk factors at 5 minutes APGAR score after adjustment.Conclusion: Leukocytosis, early onset preeclampsia, preterm birth, and thrombocytopenia, severity of preeclampsia, and HELLP syndrome are independent risks of having infant born with low APGAR score at 1 minute in preeclamptic deliveries.

Evaluating the Predictive Value of Fetal Doppler Indices and Neonatal Outcome in Late-onset Preeclampsia With Severe Features: a Cross-sectional Study in a Resource-limited Setting

“…Similar to other studies [45], we found that infants born to severely pre-eclamptic mothers had a signi cantly lower 1-and 5-minutes Apgar scores (n = 43, n = 22, respectively) compared to the control ones (p <0.001). Approximately, 35 % of neonates with a compromised Apgar score (n = 12) at 1 minute were recovered and received a score ≥7 at 5 minutes.…”

Can Inflammatory Hematological Parameters be a Guide to Late-onset Fetal Growth Restriction?

“…The Apgar score is associated with some morbidities in the neonatal period. Furthermore, some studies even suggested that the changes in Apgar scores at the 1 st and the 5 th minute were associated with a possible inflammatory process and that there was a significant relationship between the pulmonary endothelial activation and an increase in NLR, especially in cases with neonatal respiratory distress [17,32]. Similarly, in the present study, a negative relationship was determined between the 1 st -and 5 th -minute Apgar scores and NLR in late-onset FGR cases.…”

Determinants of Low APGAR score in Newborns Delivered at Lemlem Karl General Hospital, Northern Ethiopia, 2018: A Case Control Study

“…Concerning the magnitude of low Apgar score (LAS), studies conducted in Portugal, Brazil, Denmark, Iran, Indonesia, and Sweden showed prevalence's of 3.8%, 0.4%, 0.7%, 3.3%, 5.4%, and 0.7% respectively [13][14][15][16][17][18]. A previous study conducted in Ghana showed that the prevalence of LAS was 1.9% [19].…”