Prevalence and factors associated with low 5th minute APGAR score among mothers who birth through emergency cesarean section: prospective cross-sectional study in Ethiopia.

Abstract

Background: Apgar score is a method to assess the status of the baby immediately after delivery. It also used to assess the response to and overall the prognosis of the resuscitations. In Ethiopia Birth asphyxia is the one leading cause of neonatal mortality and morbidity. The APGAR score especially the 5th minute one has strong prediction of the neonatal outcome than the 1st minute APGAR score so this study focuses on identifying the prevalence and factors associated with of 5th minute APGAR score among mothers who gave birth through cesarean section in Wolkite University specialized hospital in January to June 2023 G.C.

Methods: Institution based prospective cross-sectional study was conducted by using convenience sampling on 270 Mothers, who gave birth through cesarean section in Wolkite University specialized hospital from January 1- June 30 2023 GC. The data collection was conducted through meticulous chart review and interviews. Data were entered using Epi data 7 and analyzed with SPSS 26. The association between independent variables and the 5th minute APGAR was estimated using an odds ratio with 95% confidence intervals. The statistical significance of the association was declared at P-value < 0.05.

Results: Total of 270 mothers were included and the prevalence of low fifth minute APGAR score 27.4%. multivariate logistic regression analysis showed that the predictors of low 5th minute APGAR score are fetal heart beat before intervention( bradycardia ( AOR = 9.1; 95% CI: 3.8,21.9),tachycardia ( AOR = 3.7; 95% CI: 1.5,9.8)), meconium stained Amniotic fluid (AOR = 3.0; 95% CI: 1.5,6.2), labor duration greater than 24 h ( AOR = 11.2; 95% CI: 3.9, 31.9), low birth weight( AOR = 4.3; 95% CI: 1.7,10.3).

Conclusion: A low APGAR score is highly prevalent. Fetal heart beat before intervention, meconium stained Amniotic fluid, labor duration greater than 24 h, low birth weight are statistically significant predictors of poor APGAR. Enhancing the early obstetric interventions like electronic fetal monitoring, use of partograph, and timely cesarean sections as well as early neonatal resuscitation techniques might mitigate the risk of complications linked with low APGAR scores.