title: First- and fifth-minute Apgar scores of 0-3 and infant mortality: a population-based study in São Paulo State of Brazil.
abstract: OBJECTIVE
  To determine the infant mortality of newborns with 1- and 5-min Apgar scores of 0-3.
  
  
  RESULTS
  Population cohort study with neonates with birth weight ≥400 g, gestational age ≥22 weeks and 1- and 5-min Apgar scores of 0-3, without malformations, born in São Paulo State (Brazil) from January 2006 to December 2007. Apgar scores were confirmed in the original certificates of live births and/or medical records. During this period, among 1,027,132 live births, 1640 met the study criteria, with an incidence of 1.6 per 1000 live births. When the 5-min Apgar score was 0, 1, 2 and 3, the infant mortality rate was 97%, 94%, 64% and 47%, respectively. Risk factors associated with infant deaths were 5-min Apgar score of 0 or 1 [odds ratio (OR) 16.6, 95% confidence interval (CI) 11.1-24.8], birth weight <2500 g (OR 7.5, 95% CI 5.7-9.8), birth at hospitals outside the state capital (OR 1.7, 95% CI 1.3-2.3), in private or charitable hospitals (OR 1.6, 95% CI 1.2-2.0), and during the night shift (OR 1.3, 95% CI 1.0-1.7).
  
  
  CONCLUSIONS
  For infants with 1- and 5-min Apgar scores of 0-3, the infant mortality is high. Besides the biological variables associated with the chance of dying, the organization of the perinatal care influences the outcome.
authors.forename: Ângela Cristina
authors.initials: ÂC
authors.lastname: Viau
authors.forename: Mandira Daripa
authors.initials: MD
authors.lastname: Kawakami
authors.forename: Monica La Porte
authors.initials: ML
authors.lastname: Teixeira
authors.forename: Bernadette Cunha
authors.initials: BC
authors.lastname: Waldvogel
authors.forename: Ruth
authors.initials: R
authors.lastname: Guinsburg
authors.forename: Maria Fernanda Branco de
authors.initials: MF
authors.lastname: Almeida
mesh_terms: D000293:Adolescent; D001034:Apgar Score; D001724:Birth Weight; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult