1 Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.

2 Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.

3 Department of Clinical Biochemistry, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.

4 Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.

5 Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

6 Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran AND Student Research Committee, School of Health, Ilam University of Medical Sciences, Ilam, Iran.


Background: Apgar score is a method for clinical evaluation of neonate at birth, and predicts their clinical conditions and physical or mental development. This study aimed to investigate the relationship between some neonatal and maternal factors during pregnancy on the Apgar score.
Materials and Methods: This case-control study was conducted on 234 neonates born in Ilam hospitals during 2015-2016. The case group included 81 neonates with Apgar score
Results: The mean maternal weights in the case and control groups were 66.8 ± 13.5 and 67.1 ± 11.1 Kg, respectively. The mean± SD for maternal age 29 ± 5 vs. 29 ± 5.7 years, marriage age 22 ± 3 vs. 22.2 ± 4.9 years, BMI 24.5±3.2 vs. 26.1 ± 4.1 and weight gain during pregnancy 13.8 ± 6.2 vs. 12.7 ± 6.8 kg among cases and controls, respectively. The odds ratio for the following factors was significantly higher among cases than the control group: preterm delivery (OR: 3.3, 95% CI: 1.2-17), twin birth (OR: 8.9, 95% CI: 2.6-27.2), abnormal presentation of the fetus (OR: 6, 95% CI: 2.3-15.6), birth weight (OR: 6.9, 95% CI: 1.4-28.6), and placental abruption (OR: 9.4, 95% CI: 2.2-22.5) for Apgar score at five minute.  
Conclusion: Based on the findings of the present study, preterm labor, multiple birth, and abnormal fetal presentation, and low birth weight, premature rupture of membrane, placental abruption and anemia, led to an increase in Apgar score less than 7.