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

Abstract

Background Apgar score is a practical method of systemically assessing newborn baby immediately after birth to identify those requiring resuscitation and to predict survival in neonatal period. This study was aimed to identify determinant of low fifth minute Apgar score among newborns delivered by Cesarean section. Methods An unmatched case control study design was conducted. Cases were newborns with Apgar score of < 7; controls were newborns with an Apgar score of > = 7. The study participants were selected by simple random sampling technique. Data was entered into Epi data version 4.6 and exported to SPSS software version 24. Multivariable logistic regression to identify the independent effect of different factors at P < 0.05. Result In this study, factors associated with low Apgar score (LAS) were fetal birth weight < 2.5kg [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 (PIH) (AOR = 4.58, 95% CI: 1.75 ‒ 11.92) p = 0.002, antepartum hemorrhage (APH) (AOR = 3.96; 95% CI: 1.75 ‒ 8.94) 0.001, type of anesthesia (AOR = 3.37, 95% CI: 1.72 ‒ 6.62) p = 0.001, meconium stained amniotic fluid (MSAF) (AOR = 3.07, 95% CI: 1.32 ‒ 7.12) p = 0.009 and type of cesarean section (CS) (AOR = 2.17, 95% CI: 1.13 ‒ 4.15) p = 0.019. Conclusions Fetal birth weight < 2.5kg, skin incision to delivery time, PIH, APH, type of anesthesia, MSAF and type of CS were independently associated with LAS. Therefore, it was strongly recommended that working on identified risk factors were paramount to improve then neonatal outcomes.