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

Gebremedhin, Mussie Mulugeta; Gebremichael, Mengistu Welday; Gebremichael, Berhane Gebreegizabiher; Reda, Mihrete-ab Mehari; Hailu, Tesfay Adhena; Gebremeskel, Gebrekiros Aregawi; Tlaye, Kenean Getaneh; Meikena, Henok Kumsa; Yimer, Nigus Bililign

doi:10.21203/rs.3.rs-32019/v1

Cited by 4 publications

(4 citation statements)

References 21 publications

(28 reference statements)

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“…This study revealed that neonates born to mothers with PIH were 4.58 times more likely to have LAS than their counterparts [AOR = 4.58:95% CI (1.75-11.92)]. This is in line with studies done in Lemlem Karl general hospital, Northern Ethiopia [15], Sweden and India [24,25]. This might be due to, PIH causes placental ischemia.…”

Section: Discussionsupporting

confidence: 87%

“…Regarding the APH, newborns delivered from mothers with Antepartum hemorrhage were approximately four times (AOR = 3.96, 95% CI: 1.75 -8.94) more likely to develop low Apgar score compared to their counter parts. Moreover, the likelihood of encountering low Apgar score was 3.37 times (AOR = 3.37; 95% CI: 1.72 -6.62) higher among neonates born under general anesthesia compared to spinal anesthesia [15]. In this study, the higher odds of developing low Apgar score was also observed among neonates born by emergency CS compared to elective CS (AOR = 2.17;95% CI: 1.13 -4.15).…”

Section: Determinants Of Apgar Scoresupporting

confidence: 49%

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Determinants of low fifth minute Apgar score among newborns delivered by cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: an unmatched case control study

Ajibo

Wolka

Aseffa

et al. 2022

BMC Pregnancy Childbirth

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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. Result 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..

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Section: Discussionsupporting

confidence: 87%

Section: Determinants Of Apgar Scoresupporting

confidence: 49%

Determinants of low fifth minute Apgar score among newborns delivered by cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: an unmatched case control study

Ajibo

Wolka

Aseffa

et al. 2022

BMC Pregnancy Childbirth

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“…16,30 Given APH increases the risk of compromised fetal blood perfusion, which leads to uteroplacental insufficiency, this might result in preterm birth and birth asphyxia and thereby NNM. 31,35 –37 Similarly, neonates born to a mother with premature rupture of membrane (PROM) were more likely to have NNM, a finding supported by previous studies. 10,16,19 Since association of PROM with preterm birth, respiratory distress syndrome, intravascular hemorrhage, cord prolapse, reduced amniotic fluid volume, chorioamnionitis, neonatal sepsis, and birth asphyxia was reported, 38 –40 this finding was expected.…”

Section: Discussionsupporting

confidence: 75%

Magnitude of neonatal near miss in public hospitals in Eastern Ethiopia: A cross-sectional study

et al. 2022

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Objectives: Although neonatal near miss is an emerging concept and a tool for improving neonatal care, its magnitude and associated factors are less researched in Ethiopia. Thus, this study was aimed to uncover the magnitude of neonatal near miss and its associated factors in public hospitals in Eastern Ethiopia. Methods: A facility-based cross-sectional study was employed on a randomly selected 405 mother–neonate pairs. An interview using a structured questionnaire accompanied by review of medical records was used to collect data from the mothers and records of the neonates. Neonatal near miss was defined as having any of the pragmatic (gestational age < 33 weeks, birth weight < 1750 g, and fifth minutes Apgar score < 7) or management criteria. Crude and adjusted logistic regression analysis was done to identify associated factors and presented with adjusted odds ratio with 95% confidence interval. Results: Of 401 mother–neonate pairs included in the study, 126 (31.4%, 95% confidence interval = [26.9, 36.2]) neonates had at least one neonatal near miss event at discharge. Neonatal near miss was more likely among neonates from referred women (adjusted odds ratio = 2.24, 95% confidence interval = [1.25, 4.03]), no antenatal care (adjusted odds ratio = 2.08, 95% confidence interval = [1.10, 3.93]), antepartum hemorrhage (adjusted odds ratio = 4.29, 95% confidence interval = [2.16, 8.53]), premature rupture of membrane (adjusted odds ratio = 4.07, 95% confidence interval = [2.05, 8.07]), obstructed labor (adjusted odds ratio = 2.61, 95% confidence interval = [1.23, 5.52]), non-vertex presentation (adjusted odds ratio = 3.03, 95% confidence interval = [1.54, 5.95]), and primiparous (adjusted odd ratio = 2.67, 95% confidence interval = [1.49, 4.77]). Conclusions: In this study, we found that neonatal near miss is higher than previous findings in Ethiopia. Improving neonatal near miss requires promoting antenatal care, maternal referral system, and early identification and management of obstetric complications.

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“… 9 - 11 Premature rupture of membrane (PROM), prolonged labor, meconium stain-amniotic fluid, and fetal distress were intrapartum factors. 12 - 14 Low Apgar scores at the fifth minute are associated with mortality and may cause an increased risk of cerebral palsy. 5 , 15 , 16 Prolonged labor, low birth weight, pregnancy-induced hypertensive disorders, cesarean delivery, and meconium-stained liquor were identified determinants for low five-minute Apgar score.…”

Section: Introductionmentioning

confidence: 99%

Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

Tefera

Assefa

Roba

et al. 2021

Global Pediatric Health

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The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

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

Cited by 4 publications

References 21 publications

Determinants of low fifth minute Apgar score among newborns delivered by cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: an unmatched case control study

Determinants of low fifth minute Apgar score among newborns delivered by cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: an unmatched case control study

Magnitude of neonatal near miss in public hospitals in Eastern Ethiopia: A cross-sectional study

Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

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