{
  "abstract": "Perinatal asphyxia is a leading cause of neonatal death in Mozambique and the main cause of early neonatal death in the referral hospitals of Gaza Province. Where blood gas analysis is unavailable, a low five-minute Apgar score remains a key marker of intrapartum compromise. This study aimed to identify maternal, obstetric, fetal and institutional factors associated with a low five-minute Apgar score at Xai-Xai Provincial Hospital, Mozambique. We conducted a secondary analysis of the records of 471 newborns delivered between January 2016 and December 2018, drawn from a matched case-control study of early neonatal death. The outcome was a five-minute Apgar score below 7. Associations were estimated with bivariate and multivariable conditional logistic regression and are reported as odds ratios with 95% confidence intervals. Of the 471 newborns, 76 (16.1%) had a low five-minute Apgar score. In the multivariable model, a gestational age of 42 weeks or more (adjusted odds ratio 4.04; 95% confidence interval 1.18-13.82) and ruptured membranes on admission (adjusted odds ratio 3.69; 95% confidence interval 1.37-9.96) were associated with higher odds of a low score, whereas partograph use during labour was associated with lower odds (adjusted odds ratio 0.07; 95% confidence interval 0.01-0.31). The association with preterm birth was attenuated after adjustment for birth weight. Post-term birth and ruptured membranes on admission were associated with a low five-minute Apgar score, and partograph use with lower odds. Because the sample was drawn from a study of early neonatal death, these associations should be confirmed in unselected birth cohorts. They nonetheless support strengthening intrapartum monitoring in Mozambican referral maternities.",
  "abstract_shown": true,
  "affiliations": [
    "University of Eduardo Mondlane Faculty of Medicine"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "B. Z. I. Maculuve"
    },
    {
      "name": "N. Fernandes"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c1nqmxsn1xgc4.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.13.26365388",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.13.26365388v1.full",
  "id": "c1nqmxsn1xgc4",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.13.26365388v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "pediatrics"
    ],
    [
      "openalex",
      "2735|Global Maternal and Child Health"
    ]
  ],
  "openalex": "W7221767522",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.13.26365388v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-13",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/c1nqmxsn1xgc4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:52Z",
      "native_id": "10.64898/2026.10.13.26365388",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.13.26365388v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:pediatrics",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Risk factors for a low five-minute Apgar score at a provincial referral hospital in southern Mozambique: A secondary analysis of a matched case-control study",
  "title_text": "Risk factors for a low five-minute Apgar score at a provincial referral hospital in southern Mozambique: A secondary analysis of a matched case-control study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:20:52Z",
  "url": "https://research.draconitic.com/paper/c1nqmxsn1xgc4",
  "venue": "medRxiv",
  "versions": []
}