Nabila Annisa Harum and Martono Tri Utomo and Aditiawarman and Prastiya Indra Gunawan (2021) The Correlation Between Apgar Score and Gestational Age with Neonatal Sepsis and Associated Mortality. Jurnal Widya Medika, 7 (2). pp. 141-156. ISSN 2338-0378

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Abstract

Abstract Background: Neonatal sepsis is increasingly recognized as an important global health problem that challenges neonatal survival. In 2018, sepsis caused approximately 15% of all neonatal deaths worldwide. Recent data regarding preterm birth and low Apgar score as risk factors for neonatal sepsis-related death have not been reported in Indonesia. Methods: This was a case-control study conducted in Dr.Soetomo General Hospital. A case group was obtained from medical records by a total sampling of all neonates diagnosed with neonatal sepsis in 2019, and a control group of non-neonatal sepsis cases was taken by random sampling. Chi-square test and logistic regression were used to analyze the data. Results: Statistical analysis showed a significant correlation between one and five-minute Apgar score <7 (p <0.001; OR=16.69, 95% CI 8.10 – 34.38 and p <0.001; OR=35.00, 95% CI 10.46 – 117.14, respectively) and preterm birth <37 weeks gestation (p <0.001, OR=7.78, 95% CI 4.25 – 14.26) with neonatal sepsis. The mortality rate of neonatal sepsis was 40.74%. Mortality was strongly associated with one and five-minute Apgar score 0 – 3 (p=0.047, OR=4.59, 95%CI 1.05 – 20.06 and p=0.024, OR=3.12 1.09 – 8.92 respectively), extreme preterm born <28 weeks gestation (p=0.043, OR=4.59, 95% CI 1.05 – 20.06 ) and very preterm born 28 – <32 weeks gestation (p=0.032, OR=3.12 1.09 – 8.92). Conclusion: Low Apgar score and preterm birth could make neonates more at risk of neonatal sepsis. Mortality in neonatal sepsis was significantly related with one and five-minute Apgar score 0 – 3 (severe birth asphyxia) and preterm birth <32 weeks gestation.

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