0212/2022 - PROPORÇÃO E FATORES ASSOCIADOS A APGAR MENOR QUE 7 NO 5º MINUTO DE VIDA: DE 1999 A 2019, O QUE MUDOU? PROPORTION AND FACTORS ASSOCIATED WITH APGAR LESS THAN 7 IN THE 5TH MINUTE OF LIFE: FROM 1999 TO 2019, WHAT HAS CHANGED?
Apesar da variação entre observadores na avaliação do escore de Apgar, ele permanece um indicador útil das condições gerais do recém-nascido. Trata-se de estudo de corte transversal baseado na população de nascidos vivos do Brasil no ano de 1999 e no biênio 2018-2019. Foram avaliadas todas as declarações de nascidos vivos (DNV) obtidas a partir do banco de dados do Sistema de Nascidos Vivos. As frequências foram comparadas entre os grupos por meio do teste qui-quadrado de Pearson e foi realizada análise de regressão logística multivariada. Adotou-se nível de significância estatística de 0,05. Foram analisadas 9.050.521 DNVs em nossa pesquisa. Constatamos que 2,1% dos recém-nascidos tiveram Apgar de 5º minuto < 7 em 1999 em comparação com 0,9% em 2018-2019. A análise multivariada indicou que gemelidade e gravidez na adolescência deixaram de ser fatores de risco para Apgar de 5º minuto < 7. Dentre os fatores de risco, nota-se aumento da prematuridade, baixo peso ao nascer e anomalias congênitas. Observou-se melhoria de marcadores maternos, em especial o aumento do número de consultas pré-natais e escolaridade. Tais achados mostram a importância de acesso e seguimento pré-natal adequado e investimento em melhores condições socioeconômicas como estratégia eficaz para redução de morbimortalidade neonatal.
Palavras-chave:
Asfixia neonatal. Índice de Apgar. Atenção à saúde
Abstract:
Although variation between observers in the assessment of the Apgar score, it remains a useful indicator of the general conditions of the newborn. This is a cross-sectional study based on population of live births in Brazil in 1999 and biennium 2018-2019. All declarations of live births (DNV) obtainedthe Live Births System database were accessed. Frequencies were compared between groups using Pearson\'s chi-square test and multivariate logistic regression analysis was performed. A statistical significance level of 0.05 was considered. We included 9.050.521 DNVs in our research. We found that 2,1% of newborns had 5th minute Apgar < 7 in 1999 compared with 0,9% in 2018-2019. Multivariate analysis shows that twins and teenage pregnancy are no longer risk factors. Among risk factors, we observed an increase in prematurity, low birth weight and congenital anomalies. An improvement in maternal markers was observed, especially increase in the number of prenatal consultations and schooling. Such findings demonstrate the importance access and adequate prenatal care and improved socioeconomic conditions as effective strategy to reduce neonatal morbidity and mortality.
Keywords:
Asphyxia Neonatorum. Apgar score. Delivery of Health Care.
PROPORTION AND FACTORS ASSOCIATED WITH APGAR LESS THAN 7 IN THE 5TH MINUTE OF LIFE: FROM 1999 TO 2019, WHAT HAS CHANGED?
Resumo (abstract):
Although variation between observers in the assessment of the Apgar score, it remains a useful indicator of the general conditions of the newborn. This is a cross-sectional study based on population of live births in Brazil in 1999 and biennium 2018-2019. All declarations of live births (DNV) obtainedthe Live Births System database were accessed. Frequencies were compared between groups using Pearson\'s chi-square test and multivariate logistic regression analysis was performed. A statistical significance level of 0.05 was considered. We included 9.050.521 DNVs in our research. We found that 2,1% of newborns had 5th minute Apgar < 7 in 1999 compared with 0,9% in 2018-2019. Multivariate analysis shows that twins and teenage pregnancy are no longer risk factors. Among risk factors, we observed an increase in prematurity, low birth weight and congenital anomalies. An improvement in maternal markers was observed, especially increase in the number of prenatal consultations and schooling. Such findings demonstrate the importance access and adequate prenatal care and improved socioeconomic conditions as effective strategy to reduce neonatal morbidity and mortality.
Palavras-chave (keywords):
Asphyxia Neonatorum. Apgar score. Delivery of Health Care.
Magalhães, A.L.C., Monteiro, DLM, Trajano, A.J.B., Souza, F.M.. PROPORÇÃO E FATORES ASSOCIADOS A APGAR MENOR QUE 7 NO 5º MINUTO DE VIDA: DE 1999 A 2019, O QUE MUDOU?. Cien Saude Colet [periódico na internet] (2022/Ago). [Citado em 18/09/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/proporcao-e-fatores-associados-a-apgar-menor-que-7-no-5-minuto-de-vida-de-1999-a-2019-o-que-mudou/18468?id=18468
