Antepartum and Intrapartum Risk Factors Associated with Low One-minute Apgar Score: a Case-control Study

Objective:To determine antepartum and intrapartum risk factors associated with low 1-minute Apgar score (≤ 7). A further aim was to develop a predictive model for low Apgar score at 1 minute based on significant risk factors.Materials and Methods:A case-control study was conducted by including...

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Main Authors: Sittikom Sattayaruk, Somnimit Luengratsameerung, Budsaba Wiriyasirivaj, Chadakarn Phaloprakarn
Format: Article
Language:English
Published: The Royal Thai College of Obstetricians and Gynaecologists 2014-09-01
Series:Thai Journal of Obstetrics and Gynaecology
Subjects:
Online Access:https://tci-thaijo.org/index.php/tjog/article/download/13421/18966/
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author Sittikom Sattayaruk
Somnimit Luengratsameerung
Budsaba Wiriyasirivaj
Chadakarn Phaloprakarn
author_facet Sittikom Sattayaruk
Somnimit Luengratsameerung
Budsaba Wiriyasirivaj
Chadakarn Phaloprakarn
author_sort Sittikom Sattayaruk
collection DOAJ
description Objective:To determine antepartum and intrapartum risk factors associated with low 1-minute Apgar score (≤ 7). A further aim was to develop a predictive model for low Apgar score at 1 minute based on significant risk factors.Materials and Methods:A case-control study was conducted by including 600 newborns delivered at Vajira Hospital between January 2011 and October 2012. Cases were 200 newborns with 1-minute Apgar score of ≤ 7, while controls were 400 newborns with the score of > 7. Antepartum and intrapartum characteristics were compared between both groups. The independent risk factors were determined by multivariable analysis and were transformed into components of a risk model. The performance of this model was assessed through a receiver-operating characteristic curve analysis. Results: Complete data of 600 newborns were obtained. By multivariable analysis, four antepartum and intrapartum variables were identified as independent factors associated with low 1-minute Apgar score. These included number of antenatal care, meconium stained amniotic fluid, mode of delivery and low birth weight. The independent variables were integrated into a predictive score which ranged from 0–7 points. The optimal cut-off score of ≥ 2 yielded high sensitivity of 74.5% but low specificity of 52.5% for the prediction of low 1-minute Apgar score. Conclusions: Low 1-minute Apgar score was significantly associated with number of antenatal care, meconium stained amniotic fluid, operative obstetric deliveries, and low birth weight. The risk model based on antepartum and intrapartum characteristics yielded high sensitivity but low specificity to predict low 1-minute Apgar score.
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spelling doaj.art-f18fc8253ec544529ce9afe9a282b7972022-12-21T18:26:59ZengThe Royal Thai College of Obstetricians and GynaecologistsThai Journal of Obstetrics and Gynaecology0857-60840857-60842014-09-01223118127Antepartum and Intrapartum Risk Factors Associated with Low One-minute Apgar Score: a Case-control StudySittikom Sattayaruk0Somnimit Luengratsameerung1Budsaba Wiriyasirivaj 2Chadakarn Phaloprakarn 3Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, ThailandDepartment of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, ThailandDepartment of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, ThailandDepartment of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, ThailandObjective:To determine antepartum and intrapartum risk factors associated with low 1-minute Apgar score (≤ 7). A further aim was to develop a predictive model for low Apgar score at 1 minute based on significant risk factors.Materials and Methods:A case-control study was conducted by including 600 newborns delivered at Vajira Hospital between January 2011 and October 2012. Cases were 200 newborns with 1-minute Apgar score of ≤ 7, while controls were 400 newborns with the score of > 7. Antepartum and intrapartum characteristics were compared between both groups. The independent risk factors were determined by multivariable analysis and were transformed into components of a risk model. The performance of this model was assessed through a receiver-operating characteristic curve analysis. Results: Complete data of 600 newborns were obtained. By multivariable analysis, four antepartum and intrapartum variables were identified as independent factors associated with low 1-minute Apgar score. These included number of antenatal care, meconium stained amniotic fluid, mode of delivery and low birth weight. The independent variables were integrated into a predictive score which ranged from 0–7 points. The optimal cut-off score of ≥ 2 yielded high sensitivity of 74.5% but low specificity of 52.5% for the prediction of low 1-minute Apgar score. Conclusions: Low 1-minute Apgar score was significantly associated with number of antenatal care, meconium stained amniotic fluid, operative obstetric deliveries, and low birth weight. The risk model based on antepartum and intrapartum characteristics yielded high sensitivity but low specificity to predict low 1-minute Apgar score.https://tci-thaijo.org/index.php/tjog/article/download/13421/18966/Apgar scorerisk model
spellingShingle Sittikom Sattayaruk
Somnimit Luengratsameerung
Budsaba Wiriyasirivaj
Chadakarn Phaloprakarn
Antepartum and Intrapartum Risk Factors Associated with Low One-minute Apgar Score: a Case-control Study
Thai Journal of Obstetrics and Gynaecology
Apgar score
risk model
title Antepartum and Intrapartum Risk Factors Associated with Low One-minute Apgar Score: a Case-control Study
title_full Antepartum and Intrapartum Risk Factors Associated with Low One-minute Apgar Score: a Case-control Study
title_fullStr Antepartum and Intrapartum Risk Factors Associated with Low One-minute Apgar Score: a Case-control Study
title_full_unstemmed Antepartum and Intrapartum Risk Factors Associated with Low One-minute Apgar Score: a Case-control Study
title_short Antepartum and Intrapartum Risk Factors Associated with Low One-minute Apgar Score: a Case-control Study
title_sort antepartum and intrapartum risk factors associated with low one minute apgar score a case control study
topic Apgar score
risk model
url https://tci-thaijo.org/index.php/tjog/article/download/13421/18966/
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AT somnimitluengratsameerung antepartumandintrapartumriskfactorsassociatedwithlowoneminuteapgarscoreacasecontrolstudy
AT budsabawiriyasirivaj antepartumandintrapartumriskfactorsassociatedwithlowoneminuteapgarscoreacasecontrolstudy
AT chadakarnphaloprakarn antepartumandintrapartumriskfactorsassociatedwithlowoneminuteapgarscoreacasecontrolstudy