![]() Worldwide, 4 million deaths occur annually due to birth asphyxia, representing 38 % of all deaths in children under five years of age. Birth asphyxia is a global problem, especially in developing countries and the severity of asphyxia is widely assessed using the Apgar score. Globally, nearly 7,000 newborns die every day at a rate of 19 per 1,000 live births and an estimated 23 % of neonatal deaths and 10 % of all deaths in under-five children occur as a result of the low Apgar score. Thus, the Apgar score system has a continuing value for predicting neonatal and post-neonatal adverse outcomes and is applicable to singleton and twin pregnancies and in various race/ethnic groups. If the score is below seven, the baby will continue to be monitored and re-evaluated every 5 min for up to 20 min. A five minute Apgar score of 7–10 is normal. Scores under four can call for prompt measures. Scores between 4 and 6 indicate that some assistance for breathing might be required. At the 1 min APGAR, scores between 7 and 10 indicate that the baby will need only routine post-delivery care. The score ranges from 0 to 2 for each of the five characteristics with a maximum final total score of ten (See Table 1 below). The five-minute Apgar score assesses how the baby has reacted to previous resuscitation attempts if such efforts were made. The one minute Apgar score indicates the baby’s physical health and to determine whether immediate or future medical treatment will be required. The Apgar scoring system offers a consistent assessment of infants after delivery. The APGAR is a general and quick assessment of newborn well-being immediately after birth and is recorded at one minute and five minutes from the time of birth. The risk of mortality is the highest during this period of life. The neonatal period refers to birth to the first 28 days of life and the most perilous period of life because of the numerous challenges that the neonate faces. ![]() In addition to the standard care of using electronic fetal monitoring, increasing access to compassion ships during labor and delivery is recommended. `Effective health education during preconception about anemia during pregnancy and ANC will help in detecting high-risk pregnancies that lead to a low Apgar score. Lack of physical and emotional support, rural residence, lack of ANC follow-up, low birth weight, and anemia during pregnancy were determinant factors of a low Apgar score. The area under the Apgar score ROC curve was 87.4 %. ResultsĪfter controlling for possible confounding factors, the results showed that lack of physical and emotional support during labor and delivery, rural residence, lack of antenatal care follow up, anemia during pregnancy and low birth weight were determinant factors of low Apgar scores. In the final model, variables with P < 0.05 were considered statistically significant. Binary and multivariable analyses with a 95 % confidence level were performed. Data entry and analysis were performed using Epi Data version 3.1 and SPSS version 20 respectively. A consecutive sampling technique was employed to recruit cases, while a simple random sampling technique was used to select controls. Newborns who delivered with a 5th minute Apgar score < 7 were considered as cases whereas a similar group of newborns with a 5th minute Apgar score of ≥ 7 were categorized as controls. Data were collected from 134 cases and 267 controls using a structured and pre-tested questionnaire by observing, interviewing, and reviewing patient cards. MethodsĪ hospital-based unmatched case-control study was conducted at Public Hospitals in Hawassa city. This study aimed to assess the determinants of 5th minute low Apgar score among newborns at Public hospitals in Hawassa city, South Ethiopia. Neonatal morbidity and mortality can be reduced if high-risk neonates are identified and managed adequately. It is a simple and convenient evaluation system that offers a standardized and effective assessment of newborn infants. Obstetricians worldwide have used the Apgar score for more than half a century for the assessment of immediate newborn conditions. Newborn morbidity and mortality are forecasted using the Apgar scores.
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