ArticlePloS one2023
A comparative analysis of APGAR score and the gold standard in the diagnosis of birth asphyxia at a tertiary health facility in Kenya.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 15 citations in OpenAlex.
- Involving mothers in monitoring their unborn babies during labour: experience from Liberia.BMC pregnancy and childbirth · 2026Article
- Intrapartum cardiotocographic patterns and perinatal outcomes in extremely preterm births: an exploratory retrospective cohort study.BMC pregnancy and childbirth · 2026Article
- Hypothermia-Prevalence and risk factors in neonates admitted to a neonatal unit in Tanzania.Acta paediatrica (Oslo, Norway : 1992) · 2025Observational
- Prevalence and factors associated with low 5th minute APGAR score among mothers who birth through emergency cesarean section: prospective cross-sectional study in Ethiopia.BMC pregnancy and childbirth · 2025Article
- Evaluation of criterion-based audit in improving quality of neonatal birth asphyxia care at Balaka district hospital in Malawi.Maternal health, neonatology and perinatology · 2024Article
- Correlation of cardiotocography with combined APGAR scores and diagnostic performance of umbilical cord parameters in predicting low combined APGAR scores - A prospective Cohort study.European journal of obstetrics & gynecology and reproductive biology: X · 2024Article
- Acute Kidney Injury in Neonates Admitted to a Low-Resource Neonatal Intensive Care Unit in Lusaka, Zambia.Canadian journal of kidney health and disease · 2024Article
- Increased newborn NICU admission for evaluation of hypoxic-ischemic encephalopathy during COVID-19 pandemic in a public hospital.Frontiers in pediatrics · 2023Article
- Evaluating the Effectiveness of an Evidence-Based Practice in Neonatal Resuscitation among Birth Asphyxiated Newborns in a Developing Country.SAGE open nursingArticle
- Prevalence and Associated Factors for Low Apgar Score in Central Sudan: A Cross-Sectional Study.Sage open pediatricsArticle
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBirth asphyxia is a consistent key contributor to neonatal morbidity and mortality, notably in sub-Saharan Africa. The APGAR score, though a globally used diagnostic tool for birth asphyxia, remains largely understudied especially in resource-poor settings.
objectiveThis study determined how effectively the APGAR score is used to diagnose birth asphyxia in comparison to the gold standard (umbilical cord blood pH <7 with neurologic involvement) at Moi Teaching and Referral Hospital (MTRH), and identified healthcare provider factors that affect ineffective use of the score.
methodsUsing a quantitative cross-sectional hospital-based design, term babies born in MTRH who weighed ≥2500g were randomly and systematically sampled; and healthcare providers who assign APGAR scores were enrolled via a census. Umbilical cord blood was drawn at birth and at 5minutes for pH analysis. APGAR scores assigned by healthcare providers were recorded. Effective use of the APGAR score was determined by sensitivity, specificity, positive and negative predictive values. At a significance level of 0.05, multiple logistic regression analysis identified the independent provider-associated factors affecting ineffective use of the APGAR score.
resultsWe enrolled 102 babies, and 50 (49%) were females. Among the 64 healthcare providers recruited, 40 (63%) were female and the median age was 34.5years [IQR: 31.0, 37.0]. Assigned APGAR scores had a sensitivity of 71% and specificity of 89%, with positive and negative predictive values of 62% and 92% respectively. Healthcare provider factors associated with ineffective APGAR score use included: instrumental delivery (OR: 8.83 [95% CI: 0.79, 199]), lack of access to APGAR scoring charts (OR: 56.0 [95% CI: 12.9, 322.3]), and neonatal resuscitation (OR: 23.83 [95% CI: 6.72, 101.99]).
conclusionAssigned APGAR scores had low sensitivity and positive predictive values. Healthcare provider factors independently associated with ineffective APGAR scoring include; instrumental delivery, lack of access to APGAR scoring charts, and neonatal resuscitation.
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