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Five-minute Apgar score and outcomes in neonates of 24-28 weeks' gestation

Shah, Prakesh S. (author)
Department of Paediatrics, Mount Sinai Hospital, ON, Toronto, Canada; Department of Pediatrics, University of Toronto, ON, Toronto, Canada
Norman, Mikael (author)
Karolinska Institutet
Rusconi, Franca (author)
Unit of Epidemiology, Anna Meyer Children's University Hospital and Regional Health Agency, Florence, Italy
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Kusuda, Satoshi (author)
Neonatal Research Network Japan, Maternal and Perinatal Center, Tokyo Women's Medical University, Tokyo, Japan
Reichman, Brian (author)
Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
Battin, Malcolm (author)
Department of Neonatology, Auckland District Health Board, Auckland, New Zealand
Bassler, Dirk (author)
Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
Modi, Neena (author)
UK Neonatal Collaborative, Neonatal Data Analysis Unit, Section of Neonatal Medicine, Department of Medicine, Imperial College London, London, United Kingdom
Håkansson, Stellan (author)
Umeå universitet,Pediatrik
Yang, Jie (author)
Department of Pediatrics, Mount Sinai Hospital, ON, Toronto, Canada
Lee, Shoo K. (author)
Department of Pediatrics, University of Toronto, ON, Toronto, Canada; Department of Pediatrics, Mount Sinai Hospital, ON, Toronto, Canada
Helenius, Kjell (author)
Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Medicine, University of Turku, Turku, Finland
Vento, Maximo (author)
Division of Neonatology, Health Research Institute La Fe, Valencia, Spain
Lehtonen, Liisa (author)
Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland; Department of Clinical Medicine, University of Turku, Turku, Finland
Adams, Mark (author)
Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
Isayama, Tetsuya (author)
Division of Neonatology, Center for Maternal-Fetal Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
Lui, Kei (author)
Department of Newborn Care, Royal Hospital for Women and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
Gagliardi, Luigi (author)
Division of Neonatology and Pediatrics, Ospedale Versilia, Viareggio, Italy
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 (creator_code:org_t)
2021-11-15
2022
English.
In: Archives of Disease in Childhood. - : BMJ. - 1359-2998 .- 1468-2052. ; 107:4, s. 437-446
Related links:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • OBJECTIVES: To assess associations between 5 min Apgar score and mortality and severe neurological injury (SNI) and to report test characteristics in preterm neonates. DESIGN, SETTING AND PATIENTS: Retrospective cohort study of neonates 240 to 286 weeks' gestation born between 2007 and 2016 and admitted to neonatal units in 11 high-income countries. EXPOSURE: 5 min Apgar score. MAIN OUTCOME MEASURES: In-hospital mortality and SNI defined as grade 3 or 4 periventricular/intraventricular haemorrhage or periventricular leukomalacia. Outcome rates were calculated for each Apgar score and compared after adjustment. The diagnostic characteristics and ORs for each value from 0 versus 1-10 to 0-9 versus 10, with 1-point increments were calculated. RESULTS: Among 92 412 included neonates, as 5 min Apgar score increased from 0 to 10, mortality decreased from 60% to 8%. However, no clear increasing or decreasing pattern was identified for SNI. There was an increase in sensitivity and decrease in specificity for both mortality and SNI associated with increasing scores. The Apgar score alone had an area under the curve of 0.64 for predicting mortality, which increased to 0.73 with the addition of gestational age. CONCLUSIONS: In neonates of 24-28 weeks' gestation admitted to neonatal units, higher 5 min Apgar score was associated with lower mortality in a graded manner, while the association with SNI remained relatively constant at all scores. Among survivors, low Apgar scores did not predict SNI.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Keyword

mortality
neonatology
neurology

Publication and Content Type

ref (subject category)
art (subject category)

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