Apgar Scoring System in Brazil’s Live Births Records: Differences between Home and Hospital Births

Abstract Objective To promote informed choice for women and to compare home andhospital births in relation to the Apgar score. Methods Mother’s profile and Apgar score of naturally born infants (without forceps assistance) in Brazil between 2011 and 2015, in both settings-hospital or home-were collected from live birth records provided by the Informatics Department of the Unified Health System (DATASUS, in the Portuguese acronym). For the analysis, were included only data fromlow-riskdeliveries, including gestational time between 37 and 41weeks, singleton pregnancy, at least four visits of prenatal care, infants weighing between 2,500 g, and 4,000 g, mother age between 20-40 years old, and absence of congenital anomalies. Results Home birth infants presented significantly higher risk of 0-5 Apgar scores, both in 1 minute (6.4% versus 3%, odds ratio [OR] = 2.2, confidence interval [CI] IC 2-2.4) and in 5 minutes (4.8% versus0.4%,OR = 11.5,CI 10.5-12.7). Another findingis related to recovery estimateswhen from an initially bad 1-minute Apgar ( 6). In this scenario, home infants had poorer recovery, Apgar scorewas persistently【摘要】 研究目的：本研究旨在助力女性做出知情的分娩决策，并对比家庭分娩与医院分娩的阿普加评分差异。 研究方法：本研究收集了2011至2015年巴西自然分娩（未使用产钳辅助）婴儿的产妇基线特征与阿普加评分数据，分娩地点涵盖医院与家庭两类，数据来源于巴西统一卫生系统信息部（葡萄牙语缩写为DATASUS）提供的活产登记记录。本次分析仅纳入低危分娩数据，纳入标准包括：孕周37至41周、单胎妊娠、至少4次产前检查、婴儿出生体重2500g至4000g、产妇年龄20至40岁，且无先天性畸形。 研究结果：家庭分娩婴儿的1分钟阿普加评分0~5分比例显著更高（6.4% vs 3%，比值比[OR]=2.2，置信区间[CI] 2.0~2.4），5分钟阿普加评分0~5分比例同样显著偏高（4.8% vs 0.4%，OR=11.5，CI 10.5~12.7）。另一项发现与初始1分钟阿普加评分较差（≤6分）婴儿的复苏转归相关，在此类场景下，家庭分娩婴儿的复苏效果更差，阿普加评分持续