There is an urgent need to evaluate whether the existing neonatal status assessment methods are good enough to assist obstetricians and neonatal paediatricians in assessing the needs of obstetricians and neonatologists because of the rapid increase in the number of births. After the Chinese government released its two-child policy in October 2015, many Chinese couples were allowed and encouraged to have a second child from January 1, 2016. At present, nearly all women in China choose to give birth in hospitals thus, new-borns can receive good care from healthcare workers to minimize the risk of early neonatal mortality due to avoidable causes, such as birth asphyxia. Neonatal resuscitation in immediate new-born care plays a very important and effective role in improving birth asphyxia-related outcomes. Preterm birth complications (mainly premature delivery or low birth weight), intrapartum-related complications (mainly birth asphyxia) and congenital abnormalities were the three major causes of neonatal death in China. Among all under-five deaths in 2016, 73.8% were concentrated in the infant group (age < 1 year), and 47.9% were neonatal deaths. live births) set by the Millennium Development Goals. There is still a gap between China and high-income countries in terms of sustained treatment of new-borns with low Apgar scores.Ĭhina’s national under-five mortality rate (U5MR) declined from live births in 1991 to live births in 2015, being well ahead of the target for 2015 (20. Once the baby’s Apgar score worsens, timely intervention is needed. ConclusionsĪpgar score is not only meaningful for preterm new-borns but also useful for term new-borns, especially term new-borns that are not small for gestational age. The association between Apgar score and the neonatal mortality was even stronger when scores at 1 and 5 min were combined. Among both preterm and term new-borns with Apgar scores at 5 min, new-borns that were not small for gestational age had a lower mortality rate than those that were small for gestational age. The relative risks of neonatal death-associated intermediate Apgar score at 5 min peaked at 39–40 weeks of gestation and subsequently decreased if the gestational age increased to 42 weeks or above, in contrast to the low Apgar score. Poisson regression with a robust variance estimator adjusted for a complete set of confounders was used to describe the strength of the association between the Apgar score and neonatal mortality.
Methodsĭata for all singleton live births collected from 438 hospitals between 20 were used in this study. To examine the association between the Apgar score and neonatal mortality over gestational age in China and to explore whether this association changed when Apgar scores were combined at 1 and 5 min.
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