Correlation between the Apgar score and perinatal asphyxia

Abstract

Introduction Perinatal asphyxia is defined as a decrease in blood flow or gas exchange to or from the fetus in the peripartum period. It can cause serious fetal systemic and neurologic sequelae. The incidence of perinatal asphyxia is two per 1000 births worldwide in developed countries, while the rate is up to ten times higher in developing countries, where access to maternal and neonatal care may be limited. The Apgar score is a vitality index ranging from 0 to 10 that is assigned to each newborn at one, five, and 10 minutes after birth. The score is based on measurements of the heart rate, respiratory effort, skin color, muscle tone, and reflex irritability. A total score of 7-10 is considered “normal,” and lower Apgar scores indicate decreased vitality. However, there are many causes of low Apgar score, such as perinatal asphyxia, congenital infections, maternal fever in labor, diagnosed chorioamnionitis, malformations, and preterm birth. Objectives We aimed to analyze deliveries with and without perinatal asphyxia diagnosis that took place in the Gynecology and Obstetrics Department of “Cantonal Hospital Zenica”, Bosnia, between March and May 2021. Methods and Results This is a retrospective cohort study which includes 50 patients in each arm: a study group with a diagnosis of imminent perinatal asphyxia and a control group of patients without antepartum signals of fetal asphyxia. We analyzed the delivery mode, neonatal weight and length, delivery duration and Apgar score, as possible predictors of perinatal asphyxia. Discussion and Conclusions This study has shown that abnormal CTG findings during labor are associated with perinatal asphyxia. Hence, continuous CTG monitoring during the first and second stages of labor helped to timely register the threat of perinatal asphyxia, which can be confirmed by the Apgar scores at the first and fifth minutes.