Original ArticlesThe association of Apgar score with subsequent death and cerebral palsy: A population-based study in term infants☆,☆☆
Section snippets
Methods
All children born from 1983 through 1987, a total of 259,804 births, were identified in the Medical Birth Registry of Norway. The Registry records information available at the maternity units on all births with a gestational age of 16 completed weeks or more and contains data on maternal health, the delivery, and the health of the newborn including Apgar scores at 1 and 5 minutes after birth. Ascertainment of all births is ensured through record linkage with the Central Population Register run
Results
Only 0.1% of our cohort had a 5-minute Apgar score between 0 and 3, and 0.6% had a score of 4 to 6 (Table I).Infants with a 5-minute Apgar score of 0 to 3 had neonatal and infant mortality rates of 16.4% and 19.2%, respectively. Between 1 and 8 years of age, 3.0% of the children with a 5-minute Apgar score of 0 to 3 died. Among children surviving beyond 1 year of age with a 5-minute Apgar score of 0 to 3, 6.8% were receiving benefits because of CP by the age of 8 to 12 years (Table I). Rates
Discussion
In this national cohort study, children were followed up from birth until the age of 8 to 12 years by linking data from national registries with compulsory notification. The data were validated against hospital discharge summaries and information obtained from parents. Low Apgar scores at 5 minutes were convincingly associated with subsequent death or CP, and this association was even stronger if the scores at both 1 and 5 minutes were low. Children with Apgar scores of 3 or less at both 1 and
References (32)
- et al.
Strengths and limitations of the Apgar score: a critical appraisal
J Clin Epidemiol
(1988) Perinatal asphyxia: effects of biologic and environmental risks
Clin Perinatol
(1993)- et al.
Severe asphyxia and outcome of survivors
Resuscitation
(1984) - et al.
Hypoxic-ischemic encephalopathy in term neonates: perinatal factors and outcome
J Pediatr
(1981) - et al.
Comparison of two methods of predicting outcome in perinatal asphyxia
Lancet
(1986) A proposal for a new method of evaluation of the newborn infant
Anesth Analg
(1953)Use and abuse of the Apgar score
Pediatrics
(1996)Is the Apgar score outmoded? [editorial]
Lancet
(1989)Outcome measures of obstetrical and perinatal care
Qual Assur Health Care
(1990)- et al.
Further observations on the newborn scoring system
Am J Dis Child
(1962)
The Apgar score as an index of neonatal mortality
Obstet Gynecol
Apgar scores as predictors of chronic neurologic disability
Pediatrics
Severe neonatal asphyxia. Incidence and prediction of outcome in the Stockholm area
Acta Paediatr Scand
The occurrence of placental abruption in Norway 1967-1991
Acta Obstet Gynecol Scand
The women and their pregnancies: the Collaborative Perinatal Study of The National Institute of Neurological Disease and Stroke
Cited by (230)
Neonatal Resuscitation
2023, Principles of NeonatologyFactors associated with low fifth minute Apgar score in term and preterm singleton live births in a Ghanaian hospital
2021, Journal of Neonatal NursingThe impact of the definition of preeclampsia on disease diagnosis and outcomes: a retrospective cohort study
2021, American Journal of Obstetrics and GynecologyHearing impairment after asphyxia and neonatal encephalopathy: a Norwegian population-based study
2024, European Journal of PediatricsTrends in Apgar scores and umbilical artery pH: a population-based cohort study on 10,696,831 live births in Germany, 2008–2022
2024, European Journal of Pediatrics
- ☆
Supported by a grant from the Norwegian Research Council.
- ☆☆
Reprint requests: Dag Moster, MD, Department of Pediatrics, Barneklinikken, N-5021 Bergen, Norway.