Amir Kamal Hardani , Firouzeh Nili , Mamak Shariat , Fatemeh Nayeri , Hosein Dalili ,
Volume 72, Issue 10 (January 2015)
Abstract
Background: Respecting gestational age and medical intervention at birth, Combined Apgar score, a new method proposed by American Academy of Pediatrics (AAP) may better evaluate neonatal condition at birth compared with conventional Apgar score. The combined Apgar consists of the Specified and the Expanded Apgar describe a more detailed condition at birth. In Expanded Apgar, administered intervention and in Specified Apgar, infant`s condition regardelless of gestational age and intervention are emphesised. To evaluate combined Apgar score in perinatal asphyxia, we compared conventional versus Combined Apgar scores to anticipated neonatal asphyxial complications.
Methods: In a prospective cohort study, we assessed 464 neonates admitted in, Vali-e-Asr University Hospital, during one year from September 2012 to September 2013. We assessed neonates by Conventional and Combined Apgar scoring at 1, 5 and 10 minutes after birth. Asphyxia was recognized based on newborn`s records. Diagnostic criteria for asphyxia include, occurrence of metabolic or mixed acidosis, apgar score less than three in 5th minute, occurrence of neurological complications like seizure, hypotonia, coma and multiple organ failure. Then we used SPSS V16 for data analysis and compare sensitivity between two methods of Apgar scoring.
Results: From 2200 delivered neonates, we assessed 464 neonates. 9.3% of studied neonates had Asphyxia, which equals 2% of live births. The Apgar score was lower in asphyxiated neonates by both methods (6±1 vs. 9±1 according to conventional method and 9±1 vs. 16±1 scored in combined method). Combined method was more sensitive than the Conventional Apgar scoring (99% vs. 88%).
Conclusion: In asphyxiated neonates sensitivity and specificity of combined apgar were more than conventional apgar. With respect to this study, better assessment could be achieved by combined apgar score method instead of conventional Apgar.
Morad Ali Zareipour, Shahla Mohammad Khani , Behjat Khorsandi , Faezeh Afkhami Aghda , Fateme Moshirenia, Mahdieh Hardani Naeemzadeh ,
Volume 82, Issue 1 (April 2024)
Abstract
Background: The type of delivery significantly affects a woman's life and her newborn's health. Various factors, including medical conditions, personal preferences, and cultural influences, shape this decision. Increasing cesarean delivery rates have raised concerns about associated risks. This study examines the health impacts of different delivery types on mothers and newborns in Yazd hospitals, with a focus on maternal and neonatal outcomes.
Methods: This cross-sectional analytical study involved a substantial cohort of 69,321 mothers who delivered in Yazd between March 21, 2018 to March 20, 2022. Comprehensive data were collected from Iman Hospital and relevant online patient records. To analyze the relationship between delivery type and health outcomes, independent samples t test and chi-square test were utilized. Additionally, odds ratios were calculated to assess relative risks concerning various maternal and neonatal outcomes. SPSS 26 software was employed for all analyses, with a significance level set at 5% to ensure robustness in the findings.
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Results: The average age of participants in the study was 34.45±6.44 years, highlighting a mature population of mothers. Neonatal outcomes indicated that babies delivered naturally were more likely to have unfavorable Apgar scores (ranging from four to six) when compared to infants delivered via cesarean section (CI=0.99-1.55, P=0.05, OR=1.24). Furthermore, naturally delivered infants showed a significantly higher likelihood of having Apgar scores below six (CI=0.90-1.03, P=0.001). Alarmingly, the odds of neonatal death were found to be 1.22 times higher for cesarean births (CI=1.19-1.25, P<0.001). Additionally, mothers who underwent cesarean deliveries exhibited nearly a 4.9 times higher likelihood of requiring intensive care after delivery (CI=4.71-5.12, P<0.001, OR=4.9) and were 14.3 times more likely to be hospitalized postoperatively compared to those who had natural deliveries (CI=3.53-1.31, P<0.001, OR=14.33).
Conclusion: This study indicates that cesarean delivery is associated with higher complications for both mothers and newborns, highlighting the need to promote natural childbirth for better health outcomes.
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