![]() ![]() The documentation of acidosis, especially metabolic acidosis, would then be a more objective diagnosis of hypoxia/asphyxia. ![]() Within this context and with the purpose of having a precise diagnosis of hypoxia/asphyxia, many institutions adopted the practice of collecting a sample of blood from the umbilical cord soon after birth to measure pH, blood gases, and concentration of bases. This lack of absolute correspondence between the APGAR score and hypoxia/asphyxia motivated some authorities to publish articles recommending not to consider the low APGAR score and hypoxia/asphyxia as the same condition. Most cases of low APGAR scores are secondary to neonatal hypoxia/asphyxia, but a few can have other causes such as depression by drugs, infections, and extreme prematurity. The score measured in the fifth minute is more strongly associated with short- and long-term morbidity compared to that of the score in the first minute. The score has a scale of ten points, with lower scores (scores ≤ 6) representing worse prognoses for the neonate, and is usually applied in the first and fifth minute after birth. Since then, its utilization has been widened and, currently, the APGAR score is the standard method for evaluating the condition of a neonate in most settings that offer care for birth worldwide. The APGAR score was created by the anesthesiologist Virginia Apgar in 1953 to evaluate the need for neonatal resuscitation. The time of ruptured membranes was associated with low Apgar. Prelabor cesarean had a protective effect. Twelve variables were associated with the outcome. An association of rupture of membranes more than 360 min with the outcome, even after controlling fpr duration of labor, was found adjusted OR 2.45, p = 0.023. The variables which fitted best in the model were nulliparity, male sex of the fetus, less than six prenatal visits and abnormal cardiotocography all remained significant. We conducted multivariate analysis within the group of women in labor. The values of OR were in general greater in the group of laboring women, compared with the whole group. Consequently, we conducted two sets of analyses: in the whole group and in the group of laboring women. We found a protective effect of prelabor cesarean for the outcome, odds ratio (OR) 0.38, p = 0.013. Were accessed 27 variables which could be risk factors, from which 12 were associated with the outcome. We considered significant values of p < 0.05. ![]() Non-cephalic presentations, multiples and malformations were excluded. Cases were term births with Apgar score less than 7 in the fifth minute, and controls, the next one or two births following a case, with Apgar of 7 or more. MethodsĪ retrospective case–control study with term births was conducted in a public teaching hospital from 2013 to 2020. To search for maternal, labor-related and fetal variables associated with low Apgar in the fifth minute in term pregnancy. ![]()
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