Retrospective analysis of risk factors for low 1-minute Apgar scores in term neonates

The current study was designed to investigate the perinatal risk factors for low 1-min Apgar scores in term neonates. We retrospectively analyzed the maternal and neonatal clinical data of 10,550 infants who were born through vaginal delivery from 37 weeks 0 days to 41 weeks 6 days of single gestation from January 2013 to July 2018. Because the 1-min Apgar score reflects neonatal status at birth, we analyzed the risk factors for low (score &lt;7) 1-min Apgar scores through logistic regression. Among these 10,550 neonates, 339 (3.2%) had low (score &lt;7) 1-min Apgar scores. Among them, 321 (94.7%) were admitted to the neonatology department for further observation or treatment. Multivariate analysis revealed that educational background, body mass index, gestational age, pathological obstetrics, longer duration of the second stage of labor, forceps delivery or vacuum extraction, neonatal weight, neonatal sex, and meconium-stained amniotic fluid were independent risk factors for 1-min Apgar scores &lt;7. Neonates who had low 1-min Apgar scores were more frequently admitted to the neonatology department for further observation or treatment. Early detection of risk factors and timely intervention to address these factors may improve neonatal outcomes at birth and reduce the rate of admission to the neonatology department.本研究旨在探究足月新生儿1分钟Apgar评分（Apgar score）偏低的围产期危险因素。我们对2013年1月至2018年7月期间，10550例单胎妊娠、孕37周0天至41周6天经阴道分娩的婴儿的孕产妇及新生儿临床资料进行了回顾性分析。鉴于1分钟Apgar评分可反映新生儿出生时的状态，我们通过logistic回归（logistic regression）分析了1分钟Apgar评分偏低（评分<7）的危险因素。在这10550例新生儿中，共有339例（3.2%）的1分钟Apgar评分偏低（评分<7）。其中，321例（94.7%）被收入新生儿科接受进一步观察或治疗。多因素分析结果显示，受教育程度、体质量指数、孕周、病理产科情况、第二产程延长、产钳助产或真空吸引助产、新生儿体质量、新生儿性别以及羊水胎粪污染，均为1分钟Apgar评分<7的独立危险因素。1分钟Apgar评分偏低的新生儿更易被收入新生儿科进行后续观察与治疗。早期识别此类危险因素并及时采取针对性干预措施，可改善新生儿出生结局，降低新生儿科收治率。