Relationship between APGAR score, preterm asphyxia, and initial blood gas post-resuscitation

Background: Premature infants frequently receive lower APGAR scores, which evaluate a newborn’s health after birth because of their underdeveloped organs. Research has connected APGAR score to blood gas analysis (BGA), which assesses the effectiveness of resuscitation. Objective: This study aimed to determine the relationship between the APGAR score, preterm infant asphyxia, and initial post-resuscitation blood gas measurements. Methods: This cross-sectional study investigated premature infants with respiratory disorders at the Harapan Kita National Women and Children Health Centre (NWCHC), utilizing the data collected from 2021 to 2023 and analyzing it through multiple logistic regression. Results and discussion: The APGAR score at 5 minutes (AS 5′) was found to be associated with pH (p < 0.001, OR 0.469; 95% CI 0.338–0.652) and gestational age (p = 0.029, OR 2.629; 95% CI 1.105–6.254), with birth weight considered a confounding variable. The AS 5′ also showed a relationship with the HCO3 value (p < 0.003, OR 0.674; 95% CI 0.519–0.875) and multiple pregnancies (p = 0.035, OR 2.146; 95% CI 1.056–4.632), with birth weight and gestational age as confounding variables. Conclusions: Our study found that 80% of premature infants with a 5-minute APGAR score had a pH value of ≥7.2. Infants with a score of 3 or lower were twice as likely to have a pH level above 7.2 and 1.5 times more likely to have an HCO3 level greater than 17 compared to those with higher scores. This highlights the importance of effective resuscitation in preventing asphyxia in these vulnerable infants.