Maternal factors associated with immediate low Apgar score in newborn babies at an intermediate hospital in Northern Namibia
Accepted: 15 May 2022
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Background. All newborn infants are required to undergo the Apgar score/assessment immediately after birth and again at five minutes. This vital examination is performed to determine how well the infant is adjusting to the birthing process and the outside environment. Some newborns may have a normal Apgar score, while others may have a low score. The purpose of this study was to identify factors associated with low Apgar scores among newborns at an intermediate hospital in Northern Namibia.
Objective. To identify maternal factors associated with an immediate low Apgar score in newborns at an intermediate hospital in Northern Namibia and to examine the association between maternal factors and an immediate low Apgar score. Quantitative, retrospective, descriptive research methodology was employed. A document review checklist was utilized to collect data at Onandjokwe Intermediate Hospital between August 2020 and October 2020.
Results. Gravidity (p0.021), parity (p0.029), haemoglobin after the first ante-natal care visit (p0.011), ante-partum haemorrhage (APH) (p0.004), membrane status (p0.000), duration of labour (p0.000), type of delivery (p0.000), and caesarean section type and indication (p0.000) were found to be associated with an immediate low Apgar score.
Conclusions: The study identified maternal factors that influence an infant’s initial low Apgar score. Strengthen maternal health education regarding gravidity and parity, diet, and recognizing danger signs during pregnancy. In addition, strict monitoring of patients with a partograph, cardiotocography, accurate record keeping, and prompt referral of patients with risk factors is strongly advised.
Carlos. R., Degrandi, O. The Legacy of Virginia Apgar. British Journal of Anesthesia
Khalid, M. A., Ghani, R., Khalid, M. F., et al. Association of delivery procedure with APGAR scores among neonates born to healthy Pakistani mothers: a pilot study. F1000 Research 2018;7:346.
Jeganathan, R., Karalasingam, S. D. Hussein, J., et al. Factors associated with recovery from 1-minute Apgar score<4 in live, singleton, term births: An analysis of Malaysia National obstetrics Registry data 2010-2012. BMC Pregnancy and Childbirth 2017;17:110.
Hanyanya, J. Assessment of management of new-born babies with neonatal asphyxia
at maternity units of a state hospital in Windhoek, University of Namibia. 2018.
Tewesa, E. Chirwa. E., Majamanda, M. D., et al. A. Associative Factors for Birth Asphyxia at Queen Elizabeth Central Hospital, Malawi. Journal of Biosciences and Medicines 2017;5.
Nayeri, F., Shariat, M., Dalili, H., et al. Perinatal risk factors for neonatal asphyxia in Vali-e-Asr hospital, Tehran-Iran. Iranian Journal of Reproductive Medicine 2012:137-140.
Ibrahim, N. A., Muhye, A, Abdulie. S. Prevalence of Birth Asphyxia and Associated Factors among Neonates Delivered in Dilchora referral Hospital, in Dire Dawa Ethiopia. Clinics Mother Child Health 2017;14:4.
Getachew, B., Etefa, T., Asefa, A., et al. Determinants of Low fifth minute Apgar score among Newborns Delivered in Jimma University Medical Centre, Southwest Ethiopia. International Journal of Paediatrics 2020;2020:9896127.
Abukari, A.S., Awuni, N., Yakuhu, et al. Factors associated with low fifth minute Apgar score interm and preterm singleton live births in A Ghanaian hospital. Journal of Neonatal Nursing 2021;27:476-82.
Mgaya, A.H., Massawe, S. K., Kidanto, H. L., Mgaya, H. N. Grand multi parity is it still a risk in pregnancy? BMC Pregnancy and Childbirth, 2013;13:241.
Bikisu, G. I., Muhammad, S. A., Abdullahi, M., et al. Prevalence and Risk Factors For Perinatal Asphyxia as seen at a Specialist Hospital in Gusau, Nigeria. Sub-Saharan African Journal of Medicine 2015;2:64-69.
Yimer, N.B., Tenaw, Z., Solomon, K., Mulatu. T. Inadequate Prenatal Visit and Home delivery as Determinants of Perinatal Outcomes: Does Parity Matter? Journal Pregnancy 2019;2019:9024258.
Wosenu, L., Worku, A. G., Teshome, D. F., Gelagay, A. A. Determinants of birth asphyxia among live birth newborns in university of Gondar referral hospital, northwest Ethiopia: A case-control study. PloS ONE 2018;13:9.
Namibia Inter-censal Demographic Survey Report. Namibia Statistic Agency (NSA). Windhoek, Namibia. 2016.
Namibia Demographic and Health Survey. Ministry of Health and Social Services,
Namibia Statistic Agency. Windhoek, Namibia. 2013.
Odd, O., Lewis, G., Gunnell, D., Rasmussen. Risk of low Apgar scores and socioeconomic status over a 30-year period. The journal of maternal-foetal & neonatal medicine. 2014;27:603-7.
Gudayu, T. W. Proportion and factors associated with low fourth minute Apgar score
among singleton new-born babies in Gondar University referral hospital, north-west Ethiopia. Africa Health Sciences 2017;17:1- 6.
Li, F. Wu, T. Lei, X. et al. The Apgar score and Infant mortality. PLoS One 2013;8:e69072.
Santos, N. C. P., Vogt, E.S., Duarte, D. E., et al. Factors associated with low Apgar in newborns in birth center. Rev Bras Enferm. 2019;72:297-304.
Chiabi, A., Nguefack, S., Mah, M., et al. Risk factors for birth asphyxia in an urban health facility in Cameroon. Iranian Journal of Child Neurology 2013;7:46-54.
Torres-Munoz, J., Rojas, C., Mendoza-Cuero, D., et al. Risk factors associated with the development of perinatal Asphyxia in neonates at the Hospital Universitario del Valle, Cali, Colombia. Biomedica 2017;37:51-6.
Hamulka, J., Zielinska, M.A, Chadzynska, K. The combined effects of alcohol and Tobacco use during pregancy on birth outcomes. Rocz Panstw Zakl Hig. 2018;69:45-54.
Ndidi, E. P., Oseremen, I. G. Reasons Given by pregnant women for late initiation of antenatal care in the Niger Delta. Ghana Medical Journal 2010;44:47-51.
Kebapcilar, L, Kebapcilar, A.G., Ilhan, T.T, et al. Is the Mean Platelet Volume a Predictive Marker of a Low Apgar Score and Insulin Resistance in Gestational Diabetes Mellitus? A Retrospective Case-Control Study. Journal of Clinical and Diagnostic Research. 2016;10:OC06-OC10.
Seyom, E., Abera, M., Tesfaye, M. Maternal and fetal outcome of pregnancy related
hypertension in Mettu Karl Referral Hospital, Ethiopia. Journal Ovarian Res. 2014;8:10.
Adebami, O. J. Maternal and Foetal determinants of mortality in babies with birth
asphyxia at Osogbo, Southwestern Nigeria. Global Advanced Research Journal of Medicine and Medical Science 2015;270-276.
Burgess, A., Katz, J. E., Moretti, M., Lakhi, N. Risk factors for intrapartum fever in term Gestations and Associated maternal and neonatal sequelae. Gynecol Obstet Invest. 2017;82:508-516.
Peebles, D.M, Spencer, J.A, Edwards A. D, et al. Relationship between frequency of uterine contractions and human fetal cerebral oxygen saturation studied during labour by near infrared spectroscopy. Br J Obstet Gynaecol. 1994;101:44-8.
Bakker, P.C.A, van Geijn, H.P. Uterine activity: Implications for the condition of the fetus. J Perinat Med. 2008;36:30-7.
Sori, D.A., Belete, A, Wolde. Meconium Stained Amniotic Fluid: Factors affecting Maternal and Perinatal Outcomes at Jimma University Specialized Teaching Hospital, South West Ethiopia. Gynecol Obstet 2016;394.
Omokhodion, F. O., Roberts, O.A., Onadeko, M. O., et al. I. Social, obstetric and environmental determinants of low Apgar score among infants born in four selected hospitals in Ibadan, Nigeria. Journal of Obstetrics and Gynecology 2018;38:454-60.
Obsa M.S., Getahun, M. S., Misrak, W. M., et al. Factors associated with Apgar score among Newborns Delivered by Cesarean Sections at Gandhi Memorial Hospital, Addis Ababa. Journal of Pregnancy 2020;2020:5986269.
Sahanak S. Comparison of Apgar score in Neonates: spinal versus General Anaesthesia for Elective Caesarean section. Journal of Evolution Medical and Dental Sciences 2014;539-544.
Bakhsha. F, Yousefi, Z., Aryai, M., et al. Comparison of Apgar score in newborn by vaginal delivery and spinal anesthesia and its relationship with contributing factors. J Bas Res Med Sci. 2015;10-15.
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