Predictive value of Apgar score in infants with very low birth weight.
BACKGROUND
Accurate prediction of the prognosis of infants with very low birth weight is beneficial both for their parents and for healthcare professionals.


METHODS
This was a population-based study of all low-birth-weight infants admitted to neonatal units in one region in Japan. The Apgar score at 1 and 5 min and neonatal mortality were retrospectively analyzed to obtain the predictive values of the scores. The results were stratified into two categories by birth weight and three time periods (1980-1986, 1987-1993 and 1994-2000).


RESULTS
The predictive values improved in the later years, and therefore only the data obtained in the period 1994-2000 were used. A score of less than 5 at 5 min appears to be a good predictor of neonatal mortality in infants with a birth weight between 1500 g and 2499 g (positive likelihood ratio, 17.59 [95% confidence interval (CI) 12.68-24.40]); however, there is no evidence that the score is a good predictor of neonatal mortality in infants with very low birth weight.


CONCLUSIONS
In infants with a low birth weight between 1500 g and 2499 g, an Apgar score at 5 min of less than 5 is a good predictor of neonatal mortality. The score is not useful in predicting the short-term prognosis of very low-birth-weight infants.
Mori
Rintaro
R
Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. rintaromori@gmail.com
Shiraishi
Jun
J
Negishi
Hirokuni
H
Fujimura
Masanori
M
D001034:Apgar Score; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007229:Infant Welfare; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity