While the Apgar score at 5 min is a better predictor of later outcomes than the Apgar score at 1 min, there is a necessary temporal process involved, and a neonate must pass through the first minute of life to reach the fifth. There appears to have been little or no research examining the relationship between the Apgar score at 1 min and the Apgar score at 5 min. Research has generally focused on the Apgar score at 5 min, and more specifically the relationship between the Apgar score at 5 min and future neonatal and infant outcomes. The assessment is usually made a number of times within the first ten minutes of birth, usually at 1, 5, and 10 min. The most consistently used measure of neonatal health in the few minutes after delivery is the Apgar score, providing labor ward staff with a shared understanding of a newborn’s status, and the possible need for and response to resuscitation. These are associations only, not necessarily causes, and they point to potential areas of research into health systems factors in the labour room, as well as possible biological and cultural factors. In those newborns the qualification of the person performing the delivery and the type of delivery are independent predictors of recovery as is maternal BMI and ethnicity. ConclusionsĪ 1 min Apgar score <4 is relatively rare, and less than a third recover by five minutes. Recovery was also associated with maternal obesity, and there was some ethnic variation – in the adjusted analysis indigenous (Orang Asal) Malaysians had lower odds of recovery. Among deliveries of neonates with a 1 min Apgar score <4 by doctors, after controlling for other factors, planned and unplanned CS was associated with better odds of recovery than uncomplicated vaginal deliveries. Among uncomplicated vaginal deliveries, after controlling for other factors, deliveries by a doctor of neonates with a 1 min Apgar score <4 had odds of recovery 2.4 times greater than deliveries of neonates with a 1 min Apgar score <4 by a nurse-midwife. Only 29.4% of neonates with 1 min Apgar scores <4 recover to a 5 min Apgar score ≥7. Less than 1% of births have a 1 min Apgar scores <4. Descriptive methods and bi- and multi-variable logistic regression were used to identify risk factors associated with recovery (5 min Apgar score ≥7) from 1 min Apgar scores <4. A total of 272,472 live, singleton, term births without congential anomalies were recorded, of which 1,580 (0.59%) had 1 min Apgar scores <4. MethodsĪn analysis of observational data was conducted using live, singleton, term births recorded in the Malaysian National Obstetrics Registry between 20. There has been no research looking at predictors of recovery (Apgar scores ≥7) by 5 min in neonates with 1 min Apgar scores <4. A baby, however, must pass through the first minute of life to reach the fifth. The neonatal Apgar score at 5 min has been found to be a better predictor of outcomes than the Apgar score at 1 min.
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