The association of Apgar score with subsequent death and cerebral palsy: A population-based study in term infants.
OBJECTIVE
To estimate the risk of adverse outcomes for newborns with a low Apgar score.


METHODS
Population-based cohort study. All 235,165 children born between 1983 and 1987 in Norway with a birth weight of at least 2500 g and no registered birth defects were followed up from birth to age 8 to 12 years by linkage of 3 national registries. Outcomes were death and cerebral palsy (CP).


RESULTS
Five-minute Apgar scores of 0 to 3 were recorded for 0.1%, and scores of 4 to 6 were recorded for 0.6% of the children. Compared with children who had 5-minute Apgar scores of 7 to 10, children who had scores of 0 to 3 had a 386-fold increased risk for neonatal death (95% CI: 270-552) and an 81-fold (48-138) increased risk for CP. If Apgar scores at both 1 and 5 minutes were 0 to 3, the risks for neonatal death and CP were increased 642-fold (442-934) and 145-fold (85-248), respectively, compared with scores of 7 to 10.


CONCLUSIONS
The strong association of low Apgar scores with death and CP in this population with a low occurrence of low scores shows that the Apgar score remains important for the early identification of infants at increased risk for serious and fatal conditions.
Moster
D
D
Department of Pediatrics, Haukeland University Hospital, Barneklinikken, N-5021 Bergen, Norway.
Lie
R T
RT
Irgens
L M
LM
Bjerkedal
T
T
Markestad
T
T
D001034:Apgar Score; D002547:Cerebral Palsy / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality*; D011237:Predictive Value of Tests; D012306:Risk