Investigation of the association of Apgar score with maternal socio-economic and biological factors: an analysis of German perinatal statistics.
OBJECTIVE
To examine the relationship of 5-min Apgar score with maternal socio-economic and biological factors.


METHODS
We analyzed data from 465,964 singleton pregnancies (37-41 weeks' gestation) from the German perinatal statistics of 1998-2000. Using a logistic regression model we analyzed the incidence of low (0-6) 5-min Apgar scores in relation to these maternal factors: body mass index (BMI), age, previous live births, country of origin, occupation, single mother status, working during pregnancy, and smoking.


RESULTS
A low Apgar score was more common in overweight [adjusted odds ratio (OR) 1.24; 95% confidence interval (CI) 1.10-1.40; P < 0.001] and obese [OR 1.92 (95% CI 1.67-2.20); P < 0.001] compared to normal weight women. A low Apgar score was also more common for women aged >35 years compared to those aged 20-35 years [OR 1.35 (95% CI 1.16-1.58); P < 0.001]. Furthermore, odds of a low Apgar score were higher for women with no previous live births compared to those with one or more previous live births [OR 1.52 (95% CI 1.37-1.70); P < 0.001]. Socio-economic factors did not convincingly influence Apgar scores.


CONCLUSIONS
There was an influence of the biological maternal factors age, BMI, and parity on the 5-min Apgar score. There was no convincing effect of socio-economic factors on Apgar score in our study population. Possible reasons for this are discussed.
Straube
Sebastian
S
Department of Occupational and Social Medicine, University of Göttingen, Waldweg 37 B, 37073 Göttingen, Germany. sebastian.straube@googlemail.com
Voigt
Manfred
M
Jorch
Gerhard
G
Hallier
Ernst
E
Briese
Volker
V
Borchardt
Ulrike
U
D000328:Adult; D001034:Apgar Score; D015992:Body Mass Index; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth / Q000453:epidemiology; D008423:Maternal Age; D009035:Mothers / Q000706:statistics & numerical data*; D050177:Overweight / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012923:Social Class; D014931:Women, Working / Q000706:statistics & numerical data; D055815:Young Adult