Zahra Panahi - Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Fahimeh Ghotbizadeh Vahdani - Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Saeede Eslami Khotbesara - Department of Obstetrics and Gynecology, Vali-asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
Razieh Akbari - Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Sedigheh Hantoushzadeh - Department of Gynecology and Obstetrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Soudabeh Kazemi Aski - Department of Obstetrics and Gynecology, Perinatology Reproductive Health Research Center, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
Mamak Shariat - Family Health Institute, Maternal, Fetal, and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

Background and Materials: Despite the high efficacy of the Apgar score in finding respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one of the best indicators of fetal hypoxia. Therefore, it’s so beneficial to consider these criteria and their relationship with the Apgar score for accurate diagnosis of prenatal respiratory distress retrospectively which reduces the unnecessary cesarean section (CS) rate. Methods: ۱۶۲ full-term (≥۲۵۹ days) neonates delivered by CS with the diagnosis of decreased fetal heart rate (FHR) were evaluated. ۱-min and ۵-min Apgar scores and UApH were measured. The correlation between Apgar scores with UApH and the association between UapH and Apgar with the NICU admission were evaluated. The effect of other variables including mother’s age, gravidity, gestational age, birth weight, newborn sex, and causes of decreased FHR on Apgar scores and UApH were studied as well. Results: The most common cause of decreased FHR was fetal distress, boys had higher weight (P=۰.۰۳۳) and lower UApH (P=۰.۰۴۹) than girls. Other parameters were not different significantly between both sexes. There was a positive correlation between UApH and ۱-min and ۵-min Apgar scores (r=۰.۴۶۴ and r=۰.۳۷۰ respectively) when controlled for birth weight (P<۰.۰۰۰۱). The RR for NICU admission in male acidemic neonates with abnormal ۱-min Apgar was ۱۴.۰۵ (CI۹۵%: ۵.۷-۳۴.۶) in comparison to females (RR=۱.۰۶, CI۹۵%: ۱-۱.۲۶). Conclusion: Mild acidemia (UApH<۷.۲) at least in a male fetus would be a good predictor for postnatal complications and need for NICU admission. Future studies with more samples are suggested.

Apgar, Prenatal Care, fetal hypoxia, Cesarean Section