title: The 5-minute Apgar score: survival and short-term outcomes in extremely low-birth-weight infants.
abstract: The Apgar score is a standardized tool for evaluating newborns in the delivery room. Despite its long history and widespread use, debate remains over its reliability of predicting neonatal outcomes, especially in extremely low-birth-weight premature infants. The aim of the study was to examine the relationship between the 5-minute Apgar score of extremely low-birth-weight infants, as it relates to survival and morbidities associated with prematurity and length of hospital stay. A retrospective query of the Alere neonatal database from 2001 to 2011 examined all infants less than 32 weeks' gestation and less than 1000-g birth weight. The 5-minute Apgar score was divided into 2 groups, score of 4 or greater or less than 4. The study compared results of the 5-minute Apgar score and associated morbidities in surviving infants. Statistical analyses included chi-square, Fisher exact test, t test, and multivariate regression. The sample consisted of 3898 infants with an 86.4% (n = 3366) survival rate. Controlling for gestational age and birth weight, surviving infants with a 5-minute Apgar score of less than 4 were more likely to demonstrate nonintact survival. Infants with a low 5-minute Apgar score have greater risk for mortality and morbidities associated with prematurity.
authors.affiliation: Jefferson School of Nursing, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. Ann.Phalen@jefferson.edu
authors.forename: Ann Gibbons
authors.initials: AG
authors.lastname: Phalen
authors.forename: Sharon
authors.initials: S
authors.lastname: Kirkby
authors.forename: Kevin
authors.initials: K
authors.lastname: Dysart
mesh_terms: D001034:Apgar Score; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000453:epidemiology; D007902:Length of Stay; D007969:Leukomalacia, Periventricular / Q000453:epidemiology; D055370:Lung Injury / Q000453:epidemiology; D015999:Multivariate Analysis; D011379:Prognosis; D012178:Retinopathy of Prematurity / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate; D014481:United States / Q000453:epidemiology