title: The 5-minute Apgar Score as a Prognostic Factor for Development and Progression of Retinopathy of Prematurity.
abstract: BACKGROUND
  A low Apgar score at 5 minutes has been shown to be a risk factor for development of retinopathy of prematurity (ROP).
  
  
  OBJECTIVE
  To examine the prognostic value of Apgar score at 5 minutes for development and progression of ROP.
  
  
  METHODS
  The study included 132 preterm infants who were screened from 4th week of life onward. Of these, 118 newborns were given Apgar score at 5 minutes. The prognostic significance of this index was studied as an absolute value and as a value ≤ 6. The patients were divided into two groups: group I had no evidence of ROP (n=82) and group II had some signs of ROP (n = 36). Group II was further divided into group IIA - spontaneously regressed cases (n=22), and group IIB with cases which progressed to treatment stages (n=14). We investigated 15 maternal and 20 newborn presumable risk factors for development and progression of ROP. Mann-Whitney U test, χ2 or Fisher's exact test were used in the statistical analysis. Logistic regression was performed to find significant and independent risk factors for manifestation and progression of ROP.
  
  
  RESULTS
  A low 5-minute Apgar score and an Apgar score of 6 or less at 5 minutes were not statistically significant risk factors of ROP (р=0.191, р=0.191, respectively), but were significant risk factors for the manifested ROP to progress to stages requiring treatment (p=0.046, р=0.036, respectively).
  
  
  CONCLUSIONS
  An Apgar score at 5 minutes of 6 or less was a significant and independent risk factor for progression of ROP to stages requiring treatment.
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Medical University of Plovdiv, 15A Vassil Aprilov Blvd., 4002 Plovdiv.
authors.forename: Vasil G
authors.initials: VG
authors.lastname: Marinov
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Medical University of Plovdiv, 15A Vassil Aprilov Blvd., 4002 Plovdiv.
authors.forename: Desislava N
authors.initials: DN
authors.lastname: Koleva-Georgieva
authors.affiliation: Department of Ophthalmology, Faculty of Medicine, Medical University of Plovdiv, 15A Vassil Aprilov Blvd., 4002 Plovdiv.
authors.forename: Nelly P
authors.initials: NP
authors.lastname: Sivkova
authors.affiliation: Department of Obstetrics and Gynecology, Neonatology Unit, Faculty of Medicine, Medical University of Plovdiv, Plovdiv.
authors.forename: Maya B
authors.initials: MB
authors.lastname: Krasteva
mesh_terms: D001034:Apgar Score; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D008297:Male; D011379:Prognosis; D012178:Retinopathy of Prematurity / Q000453:epidemiology*
keywords: Apgar score at 5 minutes; retinopathy of prematurity; risk factors