July 2023 · Volume 12 · Issue 7 Page 1960 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Makinde OI et al. Int J Reprod Contracept Obstet Gynecol. 2023 Jul;12(7):1960-1968 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Original Research Article Rate and determinants of low fifth minute Apgar score at the federal medical centre Yenagoa, Bayelsa State, Nigeria Olakunle I. Makinde*, Benjamin O. Awotundun, Nkencho Osegi INTRODUCTION The Apgar score was developed in 1952 for rapid evaluation of the newborn following delivery and has become a globally accepted standard for assessment of neonatal clinical status within minutes of birth. 1-4 Each of the five variables of the Apgar score is scored 0, 1, or 2 and a cumulative score of 10 is assigned. The score is determined at the first and fifth minute of life. 1-4 The need for initial resuscitation where necessary is not dependent on the Apgar score as it is often obvious before the first minute of life. 5 The assigned first minute Apgar score is the first indication of the neonate’s health status at birth. The fifth minute Apgar score is a better predictor of neonatal outcome, indicates response to resuscitation; where needed, the capacity to recover and need for further resuscitation or ongoing management. 4,6,7 The fifth minute Apgar score of 7 to 10 is interpreted as normal or reassuring, 4-6 as low or moderately abnormal and 0-3 as very low in the term and late preterm neonate. 5 For a neonate requiring further resuscitation for Apgar score <7 at the fifth minute, scores are determined at 5 minutes intervals until 20 minutes. 2-4 It is appropriate to discontinue neonatal resuscitation if it is confirmed that no heart rate has been detectable for at least 10 minutes. 4,6 Apgar score is used for diagnosis and determination of severity of perinatal asphyxia. 6,8,9 score <5 at 5 minutes and 10 minutes clearly confer an increased relative risk of neonatal mortality. 6 About 6,400 neonates die daily around DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20231904 Department of Obstetrics and Gynecology, Federal Medical Centre Yenagoa, Bayelsa State, Nigeria Received: 28 April 2023 Accepted: 02 June 2023 *Correspondence: Dr. Olakunle I. Makinde, E-mail: olakunleife@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: About a quarter of neonatal deaths and about 10% of deaths of children under 5 years are due to intrapartum related events reflected as low fifth minute Apgar score. This study is to assess the rate of low fifth minute Apgar score and its determinants at the Federal Medical Centre Yenagoa, Bayelsa State, Nigeria. Methods: A cross-sectional study of births at the Federal Medical Centre Yenagoa between July 2020 and April 2021. Data was collected in real time from parturients’ case notes at delivery. Low fift h minute Apgar score was defined as Apgar score < 7 at the 5th minute of birth. Data was analysed using IBM SPSS Statistics version 23. Multivariate logistic regression was used to identify determinants of low fifth minute Apgar score. P Value was 0.05. Results: Rate of low fifth minute Apgar score was 16.6%. Unbooked status (OR - 2.29; CI-1.11 - 4.71; p value - 0.024), emergency caesarean section (OR - 10.44; CI - 1.10 - 99.26; p value - 0.041), urgent caesarean section (OR - 25.75; CI - 2.58 – 256.72; p value=0.006) and breech presentation (OR - 1.96; CI - 1.03 – 3.82; p value=0.049) significantly increased the odd of low fifth minute Apgar score. Conclusions: Unbooked status, emergency and urgent caesarean section, and breech presentation were the determinants of low fifth minute Apgar score in the population studied. This highlights the patient group and clinical scenario requiring a focus of intervention for prevention of morbidity and mortality from low fifth minute Apgar score. Keywords: Determinants, Low fifth minute Apgar score, Nigeria, Perinatal asphyxia