Apgar Scores at 10 Minutes and Outcomes in Term and Late Preterm Neonates with Hypoxic-Ischemic Encephalopathy in the Cooling Era

Ayrapetyan, Marina; Talekar, Kiran; Schwabenbauer, Kathleen; Carola, David; Solarin, Kolawole; McElwee, Dorothy; Adeniyi-Jones, Susan; Greenspan, Jay S.; Aghai, Zubair H.

doi:10.1055/s-0038-1670637

Cited by 13 publications

(19 citation statements)

References 28 publications

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“…This study demonstrated that infants with 10 min Apgar scores of zero who received therapeutic hypothermia in Japan were more likely to survive than those in recent studies performed in Western countries7–11 13; however, they were likely to develop neurodevelopmental disabilities identified after 18 months of age. Many infants in our cohort had severe neurodevelopmental disabilities and required chronic healthcare.…”

Section: Discussionmentioning

confidence: 55%

“…Recent data in the era of therapeutic hypothermia7–10 have shown improved infant outcomes with 10-min Apgar scores of zero. Studies published after 2009, including observational series nested in therapeutic hypothermia randomised clinical trials and observational series of infants who received therapeutic hypothermia outside randomised clinical trials, showed that 44/90 (49%) term or near-term (>34 weeks of gestation) infants with Apgar scores of zero at 10 min survived and 22/90 (24%) survived without moderate or severe disabilities 7 11 12.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, the 2015 International Liaison Committee for Resuscitation recommendation was revised as follows: ’in babies with an Apgar score of zero after 10 min of resuscitation, if the heart rate remains undetectable, it may be reasonable to stop resuscitation; however, the decision to continue or discontinue resuscitative efforts should be individualised' 12. The 10-min guideline is controversial due to conflicting data on survival and neurodevelopmental outcomes among infants with Apgar scores of zero at 10 min 4–11 13. Thus, the decision to discontinue resuscitation efforts on a newborn baby when the heart rate has been undetectable for longer than 10 min remains extremely difficult.…”

Section: Introductionmentioning

confidence: 99%

“…Cultural and legal differences with respect to discontinuing resuscitation in infants who are expected to have poor prognoses may influence outcomes. However, the vast majority of recent studies are based on data from Western countries 7–13. Japan is culturally different in an overall reluctance to withhold or withdraw life-sustaining treatment 14 15.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes related to 10-min Apgar scores of zero in Japan

Shibasaki

Mukai

Tsuda

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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ObjectiveApgar scores of zero at 10 min strongly predict mortality and morbidity in infants. However, recent data reported improved outcomes among infants with Apgar scores of zero at 10 min. We aimed to review the mortality rate and neurodevelopmental outcomes of infants with Apgar scores of zero at 10 min in Japan.DesignObservational study.PatientsTwenty-eight of 768 infants registered in the Baby Cooling Registry of Japan between 2012 and 2016, at >34 weeks’ gestation, with Apgar scores of zero at 10 min who were treated with therapeutic hypothermia.InterventionsWe investigated the time of first heartbeat detection in infants with favourable outcomes and who had neurodevelopmental impairments or died.Main outcome measuresClinical characteristics, mortality rate and neurodevelopmental outcomes at 18–22 months of age were evaluated.ResultsNine (32%) of the 28 infants died before 18 months of age; 16 (57%) survived, but with severe disabilities and 3 (11%) survived without moderate-to-severe disabilities. At 20 min after birth, 14 of 27 infants (52%) did not have a first heartbeat, 13 of them died or had severe disabilities and one infant, who had the first heartbeat at 20 min, survived without disability.ConclusionOur study adds to the recent evidence that neurodevelopmental outcomes among infants with Apgar scores of zero at 10 min may not be uniformly poor. However, in our study, all infants with their first heartbeat after 20 min of age died or had severe disabilities.

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcomes related to 10-min Apgar scores of zero in Japan

Shibasaki

Mukai

Tsuda

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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“…Apgar esta prueba no fue diseñada para predecir la salud, el comportamiento, la inteligencia, la personalidad o el resultado a largo plazo de un bebé (Ayrapetyan et al, 2018). Fue diseñado para ayudar a los proveedores de atención médica a determinar la condición física general de un recién nacido para que puedan decidir rápidamente si el bebé necesita atención médica inmediata.…”

Section: Materiales Y Métodounclassified

Análisis Multivariante de la Mortalidad Neonatal, sus características y causas en el Servicio de Neonatología de un hospital de segundo nivel. 2016-2018

Guzmán

Zúñiga

Calle

et al. 2018

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El presente artículo se realiza una revisión de la mortalidad neonatal se define como el número de recién nacidos que mueren antes de alcanzar los 28 días de edad; es uno de los indicadores de calidad de atención de los servicios de salud. Aproximadamente el 60% de las muertes en el primer año de vida ocurren en el periodo. Neonatal precoz o temprano (primeros 7 días de vida). Conocer la tasa de mortalidad, características generales de los neonatos, las principales causas de muerte y los factores de riesgo. Se realizó un estudio retrospectivo y descriptivo y multivariante de los recién nacidos que fallecieron durante los primeros 28 días de vida, durante los años 2016-2018, en el hospital Teófilo Dávila de la ciudad de Machala. Se revisó todas las historias clínicas de los recién nacidos durante este periodo, encontrando 42 fallecidos, se excluyó aquellos expedientes incompletos o extraviados. Las variables estudiadas fueron edad gestacional, género, peso al nacer, tipo de nacimiento, causa de muerte, antecedentes maternos, Apgar, tiempo de hospitalización, uso de ventilación mecánica, uso de surfactante. La tasa de mortalidad por años 2016 hasta el 2018. La mortalidad neonatal fue ascendente o descendente en los tres años.

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