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La puntuación de Apgar se utiliza para evaluar la vitalidad y bienestar del recién nacido. La valoración que se realiza a los 5 minutos, es un mayor predictor de morbilidad y mortalidad neonatal. El objetivo de este estudio fue determinar los factores de riesgo perinatal asociados a gradación Apgar baja en nuestra población. Se realizó un estudio de casos y controles de la Base de Datos del Sistema Informático Perinatal, del Hospital Gineco Obstétrico “Isidro Ayora” de Quito, mediante modelos de regresión logística simple y múltiple. Los factores de riesgo perinatal que se asocian a Apgar bajo, descritos a nivel global, también se encontraron en este grupo poblacional, destacando los que provocan hipoxia perinatal como los trastornos hipertensivos en la madre. Se observó que no existe mayor prevalencia de Apgar bajo en el grupo de madres adolescentes.