Apgar Scores at 5 Minutes After Birth in Relation to School Performance at 16 Years of Age

Stuart, Andrea; Olausson, Petra Otterblad; Källén, Karin

doi:10.1097/aog.0b013e31822200eb

Cited by 68 publications

(40 citation statements)

References 20 publications

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“…In contrast, a number of larger and more robust studies have demonstrated increased risk of learning disability24 or special educational needs schooling14 25–27 among children with low Apgar scores at birth. These include a Norwegian birth cohort where children with a low Apgar score were more likely to have ASN and below-average educational performance, as reported by parents;14 three large linkage studies from the USA in which low Apgar score predicted later school-age ASN or learning disability;24–26 and a Swedish linkage study in which lack of graduation grades was used as a proxy for attendance at a special school 27. Another linkage study of Swedish boys reported that low Apgar scores, in the absence of overt encephalopathy, were associated with poorer results on cognitive testing but not school grades,15 which fits with our finding of no relationship between Apgar score and subsequent educational achievement.…”

Section: Discussionmentioning

confidence: 99%

Five-minute Apgar score and educational outcomes: retrospective cohort study of 751 369 children

Tweed

Mackay

Nelson

et al. 2015

Arch Dis Child Fetal Neonatal Ed

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Section: Discussionmentioning

confidence: 99%

Five-minute Apgar score and educational outcomes: retrospective cohort study of 751 369 children

Tweed

Mackay

Nelson

et al. 2015

Arch Dis Child Fetal Neonatal Ed

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“…Infants with low 5 minute Apgar scores often require respiratory support and have poorer future academic achievement. 33 Small for gestational age was defined as less than the sex-specific 10 th percentile of weight for each week of gestation within the Geisinger population from 2006-2013. While creating the a priori outcomes, we discovered that maternal and fetal specialists often use the electronic health record problem list to identify a pregnancy as high-risk.…”

Section: Methodsmentioning

confidence: 99%

Unconventional Natural Gas Development and Birth Outcomes in Pennsylvania, USA

et al. 2015

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Background Unconventional natural gas development has expanded rapidly. In Pennsylvania the number of producing wells increased from zero in 2005 to 3689 in 2013. To our knowledge, no prior publications have focused on unconventional natural gas development and birth outcomes. Methods We performed a retrospective cohort study using electronic health record data on 9384 mothers linked to 10946 neonates in the Geisinger Health System from January 2009-January 2013. We estimated cumulative exposure to unconventional natural gas development activity with an inverse-distance squared model that incorporated distance to the mother’s home; dates and durations of well pad development, drilling, and hydraulic fracturing; and production volume during the pregnancy. We used multilevel linear and logistic regression models to examine associations between activity index quartile and term birth weight, preterm birth, low 5 minute Apgar score and small size for gestational age, while controlling for potential confounding variables. Results In adjusted models, there was an association between unconventional natural gas development activity and preterm birth that increased across quartiles, with a fourth quartile odds ratio of 1.4 (95% CI: 1.0-1.9). There were no associations of activity with Apgar score, small for gestational age, or term birth weight (after adjustment for year). In a post-hoc analysis, there was an association with physician-recorded high-risk pregnancy identified from the problem list (fourth vs. first quartile, 1.3 [95% CI: 1.1-1.7]). Conclusion Prenatal residential exposure to unconventional natural gas development activity was associated with two pregnancy outcomes, adding to evidence that unconventional natural gas development may impact health.

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“…12 13 The 5 min Apgar score is a predictor of neonatal mortality, 14 and several neurological outcomes. [15][16][17][18][19] A suboptimal fetal environment 20 related to a low Apgar score may also be associated with compromised immune responses against tumours, 21 which can predict long-term health problems, 22 23 including future cancer risk.…”

Section: Strengths and Limitation Of This Studymentioning

confidence: 99%

The 5-minute Apgar score as a predictor of childhood cancer: a population-based cohort study in five million children

Cnattingus

Gissler

et al. 2012

BMJ Open

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ObjectiveThe aetiology of childhood cancer remains largely unknown but recent research indicates that uterine environment plays an important role. We aimed to examine the association between the Apgar score at 5 min after birth and the risk of childhood cancer.DesignNationwide population-based cohort study.SettingNationwide register data in Denmark and Sweden.Study populationAll live-born singletons born in Denmark from 1978 to 2006 (N=1 771 615) and in Sweden from 1973 to 2006 (N=3 319 573). Children were followed up from birth to 14 years of age.Main outcome measuresRates and HRs for all childhood cancers and for specific childhood cancers.ResultsA total of 8087 children received a cancer diagnosis (1.6 per 1000). Compared to children with a 5-min Apgar score of 9–10, children with a score of 0–5 had a 46% higher risk of cancer (adjusted HR 1.46, 95% CI 1.15 to 1.89). The potential effect of low Apgar score on overall cancer risk was mostly confined to children diagnosed before 6 months of age. Children with an Apgar score of 0–5 had higher risks for several specific childhood cancers including Wilms’ tumour (HR 4.33, 95% CI 2.42 to 7.73).ConclusionsA low 5 min Apgar score was associated with a higher risk of childhood cancers diagnosed shortly after birth. Our data suggest that environmental factors operating before or during delivery may play a role on the development of several specific childhood cancers.

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Apgar Scores at 5 Minutes After Birth in Relation to School Performance at 16 Years of Age

Abstract: II.

Cited by 68 publications

References 20 publications

Five-minute Apgar score and educational outcomes: retrospective cohort study of 751 369 children

Five-minute Apgar score and educational outcomes: retrospective cohort study of 751 369 children

Unconventional Natural Gas Development and Birth Outcomes in Pennsylvania, USA

The 5-minute Apgar score as a predictor of childhood cancer: a population-based cohort study in five million children

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