Determinants of low fifth minute Apgar scores among newborns at North Shoa Zone Public Hospitals in Ethiopia

Low APGAR scores are the cause of 13.6% of new born morbidity and mortality. Even though much has been done, still the levels of birth asphyxia and neonatal mortality in Ethiopia are significantly high. This study aimed to assess determinants of low fifth-minute APGAR scores among singleton new born babies. An institution-based unmatched case-control study was conducted among 426 neonates. Cases and controls were selected by systematic random sampling. Bivariable and multivariable logistic regression analyses were employed. Association was assessed by adjusted odd ratio with 95% confidence. The study found that preterm birth (AOR: 4.29; 95% CI 1.91, 9.65), lack of antenatal care (AOR: 4.32; 95% CI 1.78, 10.47), instrumental delivery (AOR: 2.75; 95% CI 1.34, 5.66), meconium-stained amniotic fluid (AOR: 2.15; 95% CI 1.16, 3.98), anemia during labour (AOR: 2.99; 95% CI 1.27, 7.05), and maternal WBC ≥ 15,000/µL (AOR: 3.13; 95% CI 1.46, 6.67)were associated with low fifth-minute Apgar scores. Low fifth-minute Apgar scores are significantly associated with preterm delivery, lack of antenatal care, instrumental births, meconium-stained amniotic fluid, maternal anemia, and elevated maternal white-blood-cell counts. Strengthening antenatal services and improving obstetric practice can help reduce these risks.