Main findings
In this nationwide Dutch study, we found a significant increase in low
5-minute Apgar scores, <7 and <4, in (near) term
liveborn singletons over the period 2010-2019. Neonatal mortality
remained unchanged. The obstetric interventions planned caesarean
section, induction of labour and epidural analgesia showed a significant
increase over the last ten years. Strikingly, instrumental vaginal
delivery and emergency caesarean section were performed less frequently
over the last 10 years, but within these obstetric intervention
subgroups the highest increase in low Apgar scores (<7 and
<4) was observed. In primary care, we observed an overall low
risk for a low Apgar score.