Increasing trends in a low 5-min Apgar score among (near) term singletons: a Dutch nationwide cohort study

C. E. Tacke; W. Onland; P. C.A.M. Bakker; F. Groenendaal; A. N. Rosman; L. Broeders; J. V. Been; T. A.J. Antonius; P. H. Dijk; K. P. Dijkman; F. A.M. van den Dungen; S. Koole; R. F. Kornelisse; F. A.B.A. Schuerman; E. van Westering-Kroon; R. S.G.M. Witlox; G. de Winter; A. C.J. Ravelli

doi:10.1038/s41372-023-01786-2

Increasing trends in a low 5-min Apgar score among (near) term singletons: a Dutch nationwide cohort study

C. E. Tacke^*, W. Onland, P. C.A.M. Bakker, F. Groenendaal, A. N. Rosman, L. Broeders, J. V. Been, T. A.J. Antonius, P. H. Dijk, K. P. Dijkman, F. A.M. van den Dungen, S. Koole, R. F. Kornelisse, F. A.B.A. Schuerman, E. van Westering-Kroon, R. S.G.M. Witlox, G. de Winter, A. C.J. Ravelli

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: To investigate trends in low Apgar scores in (near) term singletons using the Dutch Perinatal Registry. Methods: In a cohort of 1,583,188 singletons liveborn =35 weeks of gestation in the period 2010–2019, we studied trends in low 5-min Apgar scores (<7 and <4) using Cochrane Armitage trend tests. Results: The proportion of infants with low Apgar scores <7 and <4 increased significantly between 2010–2019 (1.04–1.42% (p < 0.001), 0.17–0.19% (p = 0.009), respectively). Neonatal mortality remained unchanged. Induction of labour, epidural analgesia and planned caesarean section showed an increasing trend. Instrumental vaginal delivery and emergency caesarean section were performed less frequently over time, but these intervention subgroups showed the highest relative increase in infants with low Apgar scores. Conclusions: In the Netherlands, the risk of a low 5-min Apgar score increased over the last decade. The highest relative increase was observed in subgroups of instrumental vaginal delivery and emergency caesarean section.

Original language	English
Pages (from-to)	217-223
Number of pages	7
Journal	Journal of Perinatology
Volume	44
Issue number	2
Early online date	18 Oct 2023
DOIs	https://doi.org/10.1038/s41372-023-01786-2
Publication status	Published - Feb 2024

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Tacke, C. E., Onland, W., Bakker, P. C. A. M., Groenendaal, F., Rosman, A. N., Broeders, L., Been, J. V., Antonius, T. A. J., Dijk, P. H., Dijkman, K. P., van den Dungen, F. A. M., Koole, S., Kornelisse, R. F., Schuerman, F. A. B. A., van Westering-Kroon, E., Witlox, R. S. G. M., de Winter, G., & Ravelli, A. C. J. (2024). Increasing trends in a low 5-min Apgar score among (near) term singletons: a Dutch nationwide cohort study. Journal of Perinatology, 44(2), 217-223. https://doi.org/10.1038/s41372-023-01786-2

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title = "Increasing trends in a low 5-min Apgar score among (near) term singletons: a Dutch nationwide cohort study",

abstract = "Objective: To investigate trends in low Apgar scores in (near) term singletons using the Dutch Perinatal Registry. Methods: In a cohort of 1,583,188 singletons liveborn =35 weeks of gestation in the period 2010–2019, we studied trends in low 5-min Apgar scores (<7 and <4) using Cochrane Armitage trend tests. Results: The proportion of infants with low Apgar scores <7 and <4 increased significantly between 2010–2019 (1.04–1.42% (p < 0.001), 0.17–0.19% (p = 0.009), respectively). Neonatal mortality remained unchanged. Induction of labour, epidural analgesia and planned caesarean section showed an increasing trend. Instrumental vaginal delivery and emergency caesarean section were performed less frequently over time, but these intervention subgroups showed the highest relative increase in infants with low Apgar scores. Conclusions: In the Netherlands, the risk of a low 5-min Apgar score increased over the last decade. The highest relative increase was observed in subgroups of instrumental vaginal delivery and emergency caesarean section.",

author = "Tacke, {C. E.} and W. Onland and Bakker, {P. C.A.M.} and F. Groenendaal and Rosman, {A. N.} and L. Broeders and Been, {J. V.} and Antonius, {T. A.J.} and Dijk, {P. H.} and Dijkman, {K. P.} and {van den Dungen}, {F. A.M.} and S. Koole and Kornelisse, {R. F.} and Schuerman, {F. A.B.A.} and {van Westering-Kroon}, E. and Witlox, {R. S.G.M.} and {de Winter}, G. and Ravelli, {A. C.J.}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Nature America, Inc.",

year = "2024",

month = feb,

doi = "10.1038/s41372-023-01786-2",

language = "English",

volume = "44",

pages = "217--223",

journal = "Journal of Perinatology",

issn = "0743-8346",

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Tacke, CE, Onland, W, Bakker, PCAM, Groenendaal, F, Rosman, AN, Broeders, L, Been, JV, Antonius, TAJ, Dijk, PH, Dijkman, KP, van den Dungen, FAM, Koole, S, Kornelisse, RF, Schuerman, FABA, van Westering-Kroon, E, Witlox, RSGM, de Winter, G & Ravelli, ACJ 2024, 'Increasing trends in a low 5-min Apgar score among (near) term singletons: a Dutch nationwide cohort study', Journal of Perinatology, vol. 44, no. 2, pp. 217-223. https://doi.org/10.1038/s41372-023-01786-2

TY - JOUR

T1 - Increasing trends in a low 5-min Apgar score among (near) term singletons

T2 - a Dutch nationwide cohort study

AU - Tacke, C. E.

AU - Onland, W.

AU - Bakker, P. C.A.M.

AU - Groenendaal, F.

AU - Rosman, A. N.

AU - Broeders, L.

AU - Been, J. V.

AU - Antonius, T. A.J.

AU - Dijk, P. H.

AU - Dijkman, K. P.

AU - van den Dungen, F. A.M.

AU - Koole, S.

AU - Kornelisse, R. F.

AU - Schuerman, F. A.B.A.

AU - van Westering-Kroon, E.

AU - Witlox, R. S.G.M.

AU - de Winter, G.

AU - Ravelli, A. C.J.

PY - 2024/2

Y1 - 2024/2

N2 - Objective: To investigate trends in low Apgar scores in (near) term singletons using the Dutch Perinatal Registry. Methods: In a cohort of 1,583,188 singletons liveborn =35 weeks of gestation in the period 2010–2019, we studied trends in low 5-min Apgar scores (<7 and <4) using Cochrane Armitage trend tests. Results: The proportion of infants with low Apgar scores <7 and <4 increased significantly between 2010–2019 (1.04–1.42% (p < 0.001), 0.17–0.19% (p = 0.009), respectively). Neonatal mortality remained unchanged. Induction of labour, epidural analgesia and planned caesarean section showed an increasing trend. Instrumental vaginal delivery and emergency caesarean section were performed less frequently over time, but these intervention subgroups showed the highest relative increase in infants with low Apgar scores. Conclusions: In the Netherlands, the risk of a low 5-min Apgar score increased over the last decade. The highest relative increase was observed in subgroups of instrumental vaginal delivery and emergency caesarean section.

AB - Objective: To investigate trends in low Apgar scores in (near) term singletons using the Dutch Perinatal Registry. Methods: In a cohort of 1,583,188 singletons liveborn =35 weeks of gestation in the period 2010–2019, we studied trends in low 5-min Apgar scores (<7 and <4) using Cochrane Armitage trend tests. Results: The proportion of infants with low Apgar scores <7 and <4 increased significantly between 2010–2019 (1.04–1.42% (p < 0.001), 0.17–0.19% (p = 0.009), respectively). Neonatal mortality remained unchanged. Induction of labour, epidural analgesia and planned caesarean section showed an increasing trend. Instrumental vaginal delivery and emergency caesarean section were performed less frequently over time, but these intervention subgroups showed the highest relative increase in infants with low Apgar scores. Conclusions: In the Netherlands, the risk of a low 5-min Apgar score increased over the last decade. The highest relative increase was observed in subgroups of instrumental vaginal delivery and emergency caesarean section.

U2 - 10.1038/s41372-023-01786-2

DO - 10.1038/s41372-023-01786-2

M3 - Article

SN - 0743-8346

VL - 44

SP - 217

EP - 223

JO - Journal of Perinatology

JF - Journal of Perinatology

IS - 2

ER -