Dataset Information

The association between 5-min Apgar score and mortality disappears after 24 h at the borderline of viability.

ABSTRACT: To quantify the relationship between 5-min Apgar scores and infant mortality for infants at the borderline of viability.Cohort study of 7008 infants 23-25 weeks' gestation using 2002 US National Center for Health Statistics data. Using Cox proportional-hazards models, we quantified the relationship between Apgar score and infant mortality for all infants, and then infants surviving their first 24 h. Models were adjusted for gestational age, birth weight, gender, delivery method, plurality, maternal race, marital status and education.Within one year, 46% of infants died. Of the non-survivors, deaths within 24 h were more common among infants with Apgar scores 0-3 (83%) than among infants with Apgar scores 7-10 (13%). When including all infants and adjusting for potential confounders, each 1-point increase in Apgar score decreased the hazard of mortality by 0.82. However, after excluding infants who died within 24 h, the hazard ratio increased to 0.95; although statistically significant, the practical impact was negated.For 23-25 week gestation infants surviving the first 24 h, the Apgar score loses clinical significance. Clinicians should be aware of the limitations of clinical assessments in the delivery room.

SUBMITTER: Lagatta J

PROVIDER: S-EPMC4547603 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The association between 5-min Apgar score and mortality disappears after 24 h at the borderline of viability.

Lagatta Joanne J Yan Ke K Hoffmann Raymond R

Acta paediatrica (Oslo, Norway : 1992) 20110518 6

<h4>Aim</h4>To quantify the relationship between 5-min Apgar scores and infant mortality for infants at the borderline of viability.<h4>Methods</h4>Cohort study of 7008 infants 23-25 weeks' gestation using 2002 US National Center for Health Statistics data. Using Cox proportional-hazards models, we quantified the relationship between Apgar score and infant mortality for all infants, and then infants surviving their first 24 h. Models were adjusted for gestational age, birth weight, gender, deliv ...[more]

PMID: 21535125

Similar Datasets

Project description:ObjectiveTo investigate associations between Apgar scores of 7, 8, and 9 (versus 10) at 1, 5, and 10 minutes, and neonatal mortality and morbidity.DesignPopulation based cohort study.SettingSweden.Participants1?551?436 non-malformed live singleton infants, born at term (?37 weeks' gestation) between 1999 and 2016, with Apgar scores of ?7 at 1, 5, and 10 minutes.ExposuresInfants with Apgar scores of 7, 8, and 9 at 1, 5, and 10 minutes were compared with those with an Apgar score of 10 at 1, 5, and 10 minutes, respectively.Main outcome measuresNeonatal mortality and morbidity, including neonatal infections, asphyxia related complications, respiratory distress, and neonatal hypoglycaemia. Adjusted odds ratios (aOR), adjusted rate differences (aRD), and 95% confidence intervals were estimated.ResultsCompared with infants with an Apgar score of 10, aORs for neonatal mortality, neonatal infections, asphyxia related complications, respiratory distress, and neonatal hypoglycaemia were higher among infants with lower Apgar scores, especially at 5 and 10 minutes. For example, the aORs for respiratory distress for an Apgar score of 9 versus 10 were 2.0 (95% confidence interval 1.9 to 2.1) at 1 minute, 5.2 (5.1 to 5.4) at 5 minutes, and 12.4 (12.0 to 12.9) at 10 minutes. Compared with an Apgar score of 10 at 10 minutes, the aRD for respiratory distress was 9.5% (95% confidence interval 9.2% to 9.9%) for an Apgar score of 9 at 10 minutes, and 41.9% (37.7% to 46.4%) for an Apgar score of 7 at 10 minutes. A reduction in Apgar score from 10 at 5 minutes to 9 at 10 minutes was also associated with higher odds of neonatal morbidity, compared with a stable Apgar score of 10 at 5 and 10 minutes.ConclusionsIn term non-malformed infants with Apgar scores within the normal range (7 to 10), risks of neonatal mortality and morbidity are higher among infants with lower Apgar score values, and also among those experiencing a reduction in score from 5 minutes to 10 minutes (compared with infants with stable Apgar scores of 10).

Dataset Information

The association between 5-min Apgar score and mortality disappears after 24 h at the borderline of viability.

Publications

The association between 5-min Apgar score and mortality disappears after 24 h at the borderline of viability.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets