Pregnancy and perinatal factors associated with persistently low apgar scores: An analysis of the birth records of infants born in South Australia

Abstract

This study included all newborns with Apgar scores below seven at one minute after birth who were born in 1986 and whose births were notified to the South Australian Perinatal Statistics Collection. Univariate comparisons were made of the demographic, obstetric and pregnancy outcome characteristics of the 301 newborns whose Apgar scores remained below seven at five minutes and the 3165 whose scores recovered to seven or more. The results provide a general risk profile of the 301 newborn infants who perform poorly at birth, as indicated by a low Apgar score at both one and five minutes. Adverse risk factors identified in this study were similar to those for intellectual disability (mental retardation) and cerebral palsy in South Australia. It is suggested that persisting low Apgar scores, when combined with the other risk factors demonstrated in this and previous studies, would provide more reliable prognostic information than would Apgar scores alone. The study also shows that the majority of infants with low Apgar scores at one minute scored seven or better at five minutes. This demonstrates, that although a low one minute Apgar score has value in identifying newborns in need of immediate attention, it must be supplemented by the five minute score's stronger association with perinatal morbidity.

Maternal exposure to brominated flame retardants and infant Apgar scores

“…Other risk factors for a low Apgar score reported in the literature include breech position, fetal distress, umbilical cord complications, congenital abnormalities (Jonas et al, 1990), pre–eclampsia, and anemia at delivery (Rogers and Graves, 1993). When we excluded infants who were of low birth weight or small for gestational age, had congenital anomalies or abnormal conditions at birth, or were born to mothers who had complications of labor and delivery or assisted vaginal deliveries, we did not see as strong of an association between PBB level and Apgar scores.…”

“…Electronic birth records of offspring were used to obtain Apgar scores at 1 and 5 minutes, as well as known risk factors for low scores, including the infant’s birth weight, gestational age, and method of delivery, maternal smoking and alcohol consumption during pregnancy, maternal education and payment source for hospital bill (proxies for socioeconomic status), maternal parity, complications of labor and delivery (includes presence of meconium, fetal distress, breech position), maternal hypertension during pregnancy (includes pregnancy-related hypertension and eclampsia) and maternal history of diabetes (chronic or gestational) (Catlin et al, 1986; Jonas et al, 1990; Hegyi et al, 1998; Thorngren-Jerneck and Herbst, 2001). We also considered maternal age as a risk factor, due to its association with infant birth weight and neonatal mortality (Naeye, 1983; Geronimus, 1986).…”

Intellectual disability in children aged less than seven years born moderately and late preterm compared with very preterm and term‐born children – a nationwide birth cohort study

“…Prematurity has been associated with an increased risk of ID (Stromme ; Bilder et al ; Langridge et al ). Other established prenatal and perinatal risk factors include inappropriate intrauterine growth (Leonard et al ), low birth weight (Croen et al ; Chapman et al ), maternal smoking (Drews et al ; Braun et al ), low Apgar scores (Jonas et al ; Camp et al ), intrauterine infections (Bilder et al ) and genetic disorders (Stromme ; Bilder et al ). It is important to identify prenatal and perinatal risk factors, given that improvement could lead to better obstetric and neonatal treatment practices and ultimately a reduction in prevalence of ID.…”

Risk Factors of Low APGAR Score in Japanese Full-term Deliveries: A Case-control Study.

“…In this study, we focused on a 1-minute APGAR score, which is known as a useful indicator for assessing the need for resuscitation. Quite a number of cases with low APGAR score at 1 minute have high APGAR score at 5 minutes and later, 3 , 14 and a 5-minute APGAR score is known as a useful indicator of neonatal mortality and morbidity. 3 , 15 - 17 Unfortunately, we had no data on a 5-minute APGAR score.…”