Determinants of a Low 5th Minute Apgar Score Among Preterm Neonates

Belete Fenta Kebede, Aynalem Yetwale Hiwot, Tsegaw Biyazin Tesfa, Yalemtsehay Dagnaw Genie

Abstract

Background and Aim: The Apgar (appearance, pulse, grimace, activity, and respiration) scoring system is a general and quick method of assessing neonates’ well-being immediately after birth. It plays a significant role in reducing neonatal morbidity and mortality, as it helps identify neonates with health complications so that they receive appropriate and timely treatment. This study aims to identify the determinants of a low 5th minute Apgar score among preterm neonates.

Materials and Methods: This institutional-based retrospective case–control study was conducted in preterm neonates admitted to the NICU of Mizan-Tepi University Teaching Hospital (Mizan Tepi, Southwest Ethiopia), from May 9, 2016, to December 30, 2019. Binary logistic regression method was used to analyze the determinants of a low 5th minute Apgar score. A P value of < .05 was considered to be indicative of significant associations.

Results: Our study results show that maternal rural residence (adjusted odds ratio [AOR] = 2.1, 95% CI: 1.32–3.37), multiple pregnancy (AOR = 1.64, 95% CI: 1.03–2.62), noncephalic presentation (AOR = 2.27, 95% CI: 1.05–4.930), no prenatal care (AOR = 1.86, 95% CI: 1.04–3.33), and delivery at gestational age between 28 and 31 weeks (AOR = 2.295, 95% CI: 1.31–4.02) were significantly associated with a low 5th minute Apgar score.

Conclusions: To avoid adverse neonatal outcomes, health professionals working in the prenatal care unit, delivery room, and NICU should be aware of these determinants for early detection and effective management of conditions that low Apgar scores indicate.