Correlation of Apgar Score and Umbilical Artery pH in Full-Term Newborns Delivered by Cesarean Section Due to Decreased Fetal Heart Rate

Panahi, Zahra; Ghotbizadeh Vahdani, Fahimeh; Eslami Khotbesara, Saeede; Akbari, Razieh; Hantoushzadeh, Sedigheh; Kazemi Aski, Soudabeh; Shariat, Mamak

doi:10.30699/jogcr.9.2.137

Document Type : Original Research Article

Authors

¹ Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

² Department of Obstetrics and Gynecology, Vali-asr Hospital, Tehran University of Medical Sciences, Tehran, Iran

³ Department of Obstetrics and Gynecology, Perinatology Reproductive Health Research Center, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran

⁴ Family Health Institute, Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.30699/jogcr.9.2.137

Abstract

Background & Objective: Despite the high efficacy of the Apgar score in finding respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one of the best indicators of fetal hypoxia. Therefore, it’s so beneficial to consider these criteria and their relationship with the Apgar score for accurate diagnosis of prenatal respiratory distress retrospectively which reduces the unnecessary cesarean section (CS) rate.
Materials & Methods: 162 full-term (≥259 days) neonates delivered by CS with the diagnosis of decreased fetal heart rate (FHR) were evaluated. 1-min and 5-min Apgar scores and UApH were measured. The correlation between Apgar scores with UApH and the association between UapH and Apgar with the NICU admission were evaluated. The effect of other variables including mother’s age, gravidity, gestational age, birth weight, newborn sex, and causes of decreased FHR on Apgar scores and UApH were studied as well.
Results: The most common cause of decreased FHR was fetal distress, boys had higher weight (P=0.033) and lower UApH (P=0.049) than girls. Other parameters were not different significantly between both sexes. There was a positive correlation between UApH and 1-min and 5-min Apgar scores (r=0.464 and r=0.370 respectively) when controlled for birth weight (P<0.0001). The RR for NICU admission in male acidemic neonates with abnormal 1-min Apgar was 14.05 (CI95%: 5.7-34.6) in comparison to females (RR=1.06, CI95%: 1-1.26).
Conclusion: Mild acidemia (UApH<7.2) at least in a male fetus would be a good predictor for postnatal complications and need for NICU admission. Future studies with more samples are suggested.

Keywords

Main Subjects

Maternal Fetal Medicine

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Journal of Obstetrics, Gynecology and Cancer Research

Correlation of Apgar Score and Umbilical Artery pH in Full-Term Newborns Delivered by Cesarean Section Due to Decreased Fetal Heart Rate

References

References

Volume 9, Issue 2 - Serial Number 37
March and April 2024
Pages 137-143

Correlation of Apgar Score and Umbilical Artery pH in Full-Term Newborns Delivered by Cesarean Section Due to Decreased Fetal Heart Rate

References

References

Volume 9, Issue 2 - Serial Number 37March and April 2024Pages 137-143

Volume 9, Issue 2 - Serial Number 37
March and April 2024
Pages 137-143