The relationship between Apgar score, umbilical artery pH and operative delivery for fetal distress in 2778 infants born at term.
A total of 2778 infants born at term were studied to determine the relationship between Apgar scores after 1 min, umbilical artery pH values, mode of delivery, a diagnosis of fetal distress leading to operative delivery, and sex. Eighty-three percent of the population had normal Apgar scores (greater than or equal to 8) and normal pH values (greater than 7.15) in which 10% were operatively delivered for fetal distress (ODFD). Sixty-one percent of the children with low Apgar scores (less than or equal to 7) had normal pH values, and 74% of the infants with acidosis (pH less than or equal to 7.15) had normal Apgar score. Twenty-four percent of the infants with a low Apgar score and/or acidosis were ODFD (sensitivity). Ninety percent of the infants who had Apgar scores and pH values were not ODFD (specificity). The predictive value (a low Apgar score and/or acidosis) of ODFD was 33%, and the negative predictive value (normal Apgar score and a normal pH) of ODFD was 85%. A significantly higher incidence of ODFD and acidosis was found in boys.
Hoffmann
A L
AL
Department of Obstetrics and Gynecology, Arhus Municipal Hospital, University of Arhus, Denmark.
Hjortdal
J O
JO
Secher
N J
NJ
Weile
B
B
D000138:Acidosis / Q000097:blood*; D001034:Apgar Score; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D005316:Fetal Distress / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D012307:Risk Factors; D012737:Sex Factors; D014469:Umbilical Arteries