title: Newborn assessment and long-term adverse outcome: a systematic review.
abstract: The medical literature was searched for publications between 1966 and September 1997 for data on the association of Apgar score, umbilical blood pH, or Sarnat grading of encephalopathy with long-term adverse outcome. Odds ratios for these associations were combined to calculate common odds ratios with 95% confidence intervals. Our search identified abstracts of 1312 studies and 81 articles with sufficient numeric data to formulate contingency tables. Forty-two of these qualified for inclusion in our meta-analysis. The strongest associations in the prediction of neonatal death were found by comparing umbilical artery pH <7 with pH >/=7 (common odds ratio 43; 95% confidence interval 15-124) and by comparing Sarnat grade III with grade II (common odds ratio 24; 95% confidence interval 13-45). In the prediction of cerebral palsy, the strongest associations were found for Sarnat grade III versus grade II (common odds ratio 20; 95% confidence interval 6-70) and for 20-minute Apgar score 0 to 3 versus 4 to 6 (common odds ratio 15; 95% confidence interval 5-50).
authors: Department of Obstetrics and Gynaecology and the Department of Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands.
authors: J E
authors: JE
authors: van de Riet
authors: F P
authors: FP
authors: Vandenbussche
authors: S
authors: S
authors: Le Cessie
authors: M J
authors: MJ
authors: Keirse
mesh_terms: D001034:Apgar Score; D002547:Cerebral Palsy / Q000453:epidemiology; D005312:Fetal Blood / Q000737:chemistry; D005500:Follow-Up Studies; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007226:Infant Mortality; D007231:Infant, Newborn; D016017:Odds Ratio; D010808:Physical Examination; D012307:Risk Factors