Baixos índices de Apgar no quinto minuto de vida em população de baixo risco: Fatores maternos e obstétricos e resultados pós-natais

Translated title of the contribution: Low Apgar scores at 5 minutes in a low risk population: Maternal and obstetrical factors and postnatal outcome

Eugenia Maria Assunção Salustiano, Juliana Alvares Duarte Bonini Campos, Silvia Maria Ibidi, Rodrigo Ruano, Marcelo Zugaib

Research output: Contribution to journalReview article

14 Citations (Scopus)

Abstract

Objective: To evaluate the association between Apgar scores of less than seven at five minutes (AS5min < 7) and antenatal factors and postnatal outcomes. Methods: A retrospective cohort and case-control study of 27,252 consecutive term newborns in a low risk obstetrical population between January 2003 and December 2010. Maternal and infant databases were reviewed from all cases with AS5min < 7 (n = 121; 0.4%) and 363 cases with AS5min ≥ 7 at 5 minutes who were randomly selected by a computer program. The main outcomes were neonatal death, newborn respiratory distress, need for orotracheal intubation and neonatal intensive care unit (NICU), and hypoxic-ischemic-encephalopathy. Results: After multiple regression analysis, repeated late decelerations on cardiotocography (OR: 2.4; 95% CI: 1.4-4.1) and prolonged second stage of labor (OR: 3.3; 95% CI: 1.3-8.3) were associated with AS5min < 7, as well as neonatal respiratory distress (OR: 3.0; 95% CI: 1.3-6.9), orotracheal intubation (OR: 2.5; 95% CI: 1.2-4.8), need for NICU (OR: 9.5; 95% CI: 6.7-16.8), and hypoxic-ischemicencephalopathy (OR: 14.1; 95% CI: 3.6-54.7). No other antenatal factors were associated with AS5min < 7 (p > 0.05). Conclusion: Repeated late decelerations and prolonged second stage of labor in the low-risk population are predictors of AS5min < 7, a situation associated with increased risk of neonatal respiratory distress, need for mechanical ventilatory support and NICU, and hypoxic-ischemic-encephalopathy.

Original languagePortuguese
Pages (from-to)587-593
Number of pages7
JournalRevista da Associacao Medica Brasileira
Volume58
Issue number5
StatePublished - Jan 1 2012
Externally publishedYes

Fingerprint

Apgar Score
Mothers
Second Labor Stage
Brain Hypoxia-Ischemia
Deceleration
Population

Keywords

  • Apgar scores
  • Asphyxia
  • Delivery
  • Hypoxic-ischemic-encephalopathy
  • Neonatal mortality
  • Term

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Baixos índices de Apgar no quinto minuto de vida em população de baixo risco : Fatores maternos e obstétricos e resultados pós-natais. / Salustiano, Eugenia Maria Assunção; Campos, Juliana Alvares Duarte Bonini; Ibidi, Silvia Maria; Ruano, Rodrigo; Zugaib, Marcelo.

In: Revista da Associacao Medica Brasileira, Vol. 58, No. 5, 01.01.2012, p. 587-593.

Research output: Contribution to journalReview article

Salustiano, Eugenia Maria Assunção ; Campos, Juliana Alvares Duarte Bonini ; Ibidi, Silvia Maria ; Ruano, Rodrigo ; Zugaib, Marcelo. / Baixos índices de Apgar no quinto minuto de vida em população de baixo risco : Fatores maternos e obstétricos e resultados pós-natais. In: Revista da Associacao Medica Brasileira. 2012 ; Vol. 58, No. 5. pp. 587-593.
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abstract = "Objective: To evaluate the association between Apgar scores of less than seven at five minutes (AS5min < 7) and antenatal factors and postnatal outcomes. Methods: A retrospective cohort and case-control study of 27,252 consecutive term newborns in a low risk obstetrical population between January 2003 and December 2010. Maternal and infant databases were reviewed from all cases with AS5min < 7 (n = 121; 0.4{\%}) and 363 cases with AS5min ≥ 7 at 5 minutes who were randomly selected by a computer program. The main outcomes were neonatal death, newborn respiratory distress, need for orotracheal intubation and neonatal intensive care unit (NICU), and hypoxic-ischemic-encephalopathy. Results: After multiple regression analysis, repeated late decelerations on cardiotocography (OR: 2.4; 95{\%} CI: 1.4-4.1) and prolonged second stage of labor (OR: 3.3; 95{\%} CI: 1.3-8.3) were associated with AS5min < 7, as well as neonatal respiratory distress (OR: 3.0; 95{\%} CI: 1.3-6.9), orotracheal intubation (OR: 2.5; 95{\%} CI: 1.2-4.8), need for NICU (OR: 9.5; 95{\%} CI: 6.7-16.8), and hypoxic-ischemicencephalopathy (OR: 14.1; 95{\%} CI: 3.6-54.7). No other antenatal factors were associated with AS5min < 7 (p > 0.05). Conclusion: Repeated late decelerations and prolonged second stage of labor in the low-risk population are predictors of AS5min < 7, a situation associated with increased risk of neonatal respiratory distress, need for mechanical ventilatory support and NICU, and hypoxic-ischemic-encephalopathy.",
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AU - Campos, Juliana Alvares Duarte Bonini

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AU - Ruano, Rodrigo

AU - Zugaib, Marcelo

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N2 - Objective: To evaluate the association between Apgar scores of less than seven at five minutes (AS5min < 7) and antenatal factors and postnatal outcomes. Methods: A retrospective cohort and case-control study of 27,252 consecutive term newborns in a low risk obstetrical population between January 2003 and December 2010. Maternal and infant databases were reviewed from all cases with AS5min < 7 (n = 121; 0.4%) and 363 cases with AS5min ≥ 7 at 5 minutes who were randomly selected by a computer program. The main outcomes were neonatal death, newborn respiratory distress, need for orotracheal intubation and neonatal intensive care unit (NICU), and hypoxic-ischemic-encephalopathy. Results: After multiple regression analysis, repeated late decelerations on cardiotocography (OR: 2.4; 95% CI: 1.4-4.1) and prolonged second stage of labor (OR: 3.3; 95% CI: 1.3-8.3) were associated with AS5min < 7, as well as neonatal respiratory distress (OR: 3.0; 95% CI: 1.3-6.9), orotracheal intubation (OR: 2.5; 95% CI: 1.2-4.8), need for NICU (OR: 9.5; 95% CI: 6.7-16.8), and hypoxic-ischemicencephalopathy (OR: 14.1; 95% CI: 3.6-54.7). No other antenatal factors were associated with AS5min < 7 (p > 0.05). Conclusion: Repeated late decelerations and prolonged second stage of labor in the low-risk population are predictors of AS5min < 7, a situation associated with increased risk of neonatal respiratory distress, need for mechanical ventilatory support and NICU, and hypoxic-ischemic-encephalopathy.

AB - Objective: To evaluate the association between Apgar scores of less than seven at five minutes (AS5min < 7) and antenatal factors and postnatal outcomes. Methods: A retrospective cohort and case-control study of 27,252 consecutive term newborns in a low risk obstetrical population between January 2003 and December 2010. Maternal and infant databases were reviewed from all cases with AS5min < 7 (n = 121; 0.4%) and 363 cases with AS5min ≥ 7 at 5 minutes who were randomly selected by a computer program. The main outcomes were neonatal death, newborn respiratory distress, need for orotracheal intubation and neonatal intensive care unit (NICU), and hypoxic-ischemic-encephalopathy. Results: After multiple regression analysis, repeated late decelerations on cardiotocography (OR: 2.4; 95% CI: 1.4-4.1) and prolonged second stage of labor (OR: 3.3; 95% CI: 1.3-8.3) were associated with AS5min < 7, as well as neonatal respiratory distress (OR: 3.0; 95% CI: 1.3-6.9), orotracheal intubation (OR: 2.5; 95% CI: 1.2-4.8), need for NICU (OR: 9.5; 95% CI: 6.7-16.8), and hypoxic-ischemicencephalopathy (OR: 14.1; 95% CI: 3.6-54.7). No other antenatal factors were associated with AS5min < 7 (p > 0.05). Conclusion: Repeated late decelerations and prolonged second stage of labor in the low-risk population are predictors of AS5min < 7, a situation associated with increased risk of neonatal respiratory distress, need for mechanical ventilatory support and NICU, and hypoxic-ischemic-encephalopathy.

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KW - Hypoxic-ischemic-encephalopathy

KW - Neonatal mortality

KW - Term

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