Mortality and immediate morbidity in term babies with low Apgar scores (Zimbabwe).

A retrospective study was undertaken to document immediate morbidity and mortality associated with low Apgar scores (5 or less) at 5 minutes in singleton term babies (37 weeks or more). From October 1986-February 1987 84 term babies had low Apgar scores giving an incidence of 15/1000 livebirths. Overall mortality in these patients was 42% and in those in whom Apgar scores remained 0-3 at 5 minutes mortality was 77%. Evidence of severe-to-moderate hypoxic-ischemic encephalopathy was noted in 44 (52%) and 17 (20%) failed to establish spontaneous respiration within the 1st few hours of life. Meconium aspiration syndrome was diagnosed in 29 (35%). A control group of 141 term babies with 5-minute Apgar scores of 7 or more were identified and the presence of possible risk factors associated with low Apgar was assessed. Primiparity and prolonged 2nd stages of labor in all parities were found to be significantly associated with low Apgar scores. Improved obstetric care and appropriate management of the newborn at delivery and in the neonatal period may help to reduce mortality and morbidity in some term babies. (authors)