FACTORS ASSOCIATED WITH APGAR SCORE AMONG NEWBORNS DELIVERED BY CESAREAN SECTIONS; A CROSS-SECTIONAL STUDY

Abstract

Introduction: Despite the widespread utilization of the Apgar score as a critical tool for assessing neonatal well-being following cesarean section (C/S) deliveries. To investigate the factors associated with Apgar score among newborns delivered by cesarean section.

Material & Methods: A cross-sectional was conducted to examine factors associated with Apgar scores in neonates delivered via cesarean section. All eligible parturient were included, and rigorous training was provided to data collectors. Bivariate and multivariate analyses were employed to identify factors associated with Apgar scores, with logistic regression models used to assess associations.

Results: The majority of participants were aged 25-29 (38.22%) years, with Gravida II (44.59%) being the most prevalent pregnancy state. Single gestation (94.27%) was predominant, and most (91.40%) mothers had a normal medical condition, undergoing emergency cesarean sections with spinal anesthesia. Newborns were evenly distributed by sex, with a majority weighing between 2.5-4kg and being born at term gestation, exhibiting favorable Apgar scores. Factors influencing neonatal outcomes included spinal anesthesia being associated with better outcomes compared to general anesthesia, while prolonged skin incision to delivery times (>3 minutes) (OR: 1.2, 95%CI:1.0-1.4) and uterine incision to delivery times (>3 minutes) (OR: 1.2, 95% CI: 1.0-1.4) were linked to adverse outcomes. Higher birth weight (2.5-4 kg) (OR: 1.5, 95% CI: 1.3-1.7), normotension (OR: 1.1, 95% CI: 1.0-1.3), term gestation (OR: 16, 95% CI: 14-18), and single gestation (OR: 34, 95% CI: 32-36) were associated with better outcomes compared to their respective counterparts.

Conclusion: Optimizing perioperative factors such as anesthesia type and incision times affecting neonatal outcomes in cesarean deliveries. Moreover, the observed associations between favorable neonatal outcomes and factors like higher birth weight, term gestation, normotension, and single gestation underscore the importance of comprehensive obstetric care strategies in enhancing maternal and neonatal health during cesarean sections.