Results:
The proportion of infants with low 5-minute Apgar score <7 and <4 increased significantly between 2010 and 2019 (1.04-1.42% (p<0.001), 0.17-0.19% (p=0.009), respectively). While neonatal mortality remained unchanged, NICU admissions and low umbilical artery pH’s increased significantly. Many perinatal characteristics showed a significant association with low Apgar scores. The highest risks were found for nulliparity, epidural analgesia, emergency caesarean section, instrumental vaginal delivery, prolonged second stage of labour, male sex and delivery in secondary care. The obstetric interventions induction of labour, epidural analgesia and planned caesarean section showed an increasing trend. Instrumental vaginal delivery and emergency caesarean section were performed less frequently over time, however within these obstetric intervention subgroups the highest increase in low Apgar scores was observed.