Outcome after successful resuscitation of babies born with apgar scores of 0 at both 1 and 5 minutes.
OBJECTIVE
Our purpose was to evaluate the outcome of infants who underwent successful resuscitation after initial Apgar scores of 0 at both 1 and 5 minutes.


METHODS
Eligible infants were identified through the perinatal database at the University of Tennessee, Memphis. Hospital records and long-term outcomes, where available, of babies who met the above criteria occurring between January 1986 and February 1999 were reviewed.


RESULTS
Thirty-three of 81,603 infants (0.4/1000 births) met our study criteria. Twenty-two (67%) babies died during hospitalization. Mortality decreased significantly from 100% for babies with a birth weight of <750 g to 38% for those weighing > or =2500 g at birth (P =.03). All 6 babies delivered before 26 weeks' gestation died. The incidence of 10-minute Apgar scores >0 was significantly higher among survivors than among those who subsequently died (82% vs 33%, P <.05). Nine survivors had hypoxic-ischemic encephalopathy diagnosed before discharge. Of the 7 infants with available follow-up, 4 had significant persisting morbidity. Two infants had normal neurologic examinations at follow-up.


CONCLUSIONS
Survival in babies born with 1- and 5-minute Apgar scores of 0 is predicted by birth weight, gestational age, and 10-minute Apgar score. Long-term sequelae are common but not ensured.
Haddad
B
B
Departments of Obstetrics and Gynecology, University of Tennessee, Memphis, USA.
Mercer
B M
BM
Livingston
J C
JC
Talati
A
A
Sibai
B M
BM
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D002423:Cause of Death; D002547:Cerebral Palsy / Q000175:diagnosis; D005260:Female; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis; D007226:Infant Mortality; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000175:diagnosis; D007969:Leukomalacia, Periventricular / Q000175:diagnosis; D011247:Pregnancy; D012151:Resuscitation; D016896:Treatment Outcome; D014469:Umbilical Arteries