The Apgar score revisited: Influence of gestational age

Catlin, Elizabeth A.; Carpenter, Marshall W.; Brann, Benjamin S; Mayfield, Steven; Shaul, Philip W.; Goldstein, Marshall; Oh, William

doi:10.1016/s0022-3476(86)80715-6

Cited by 178 publications

(93 citation statements)

References 8 publications

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“…According to this study, these premature babies presented 359 times more of a chance of neonatal death in the first week of life and more than 30 times for neonatal death up to 28 days of life (22) . Low Apgar scores in premature newborns are observed even in the absence of indicators of fetal distress, and are due to physiological immaturity with a decrease of grimace and an inability to respond in an autonomous manner to cardiovascular and respiratory functions (23)(24) . In this study, low birth weight showed a strong association with premature births.…”

Section: Discussionmentioning

confidence: 99%

Maternal and neonatal factors related to prematurity

Oliveira

Gonçalves

Costa

et al. 2016

Rev. esc. enferm. USP

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Objective:To identify maternal and neonatal factors associated with prematurity in the municipality of Porto Alegre. Method: This was a population-based case-control study. The cases were newborns under 37 weeks of gestation and the controls were newborns over 37 weeks. The data came from the records of 19,457 births in the city of Porto Alegre in the year 2012 from the Information System on Live Births of the Municipal Health Department. The analysis was carried out and adjusted by a Logistic Regression according to a hierarchical model. The variables studied were allocated into three hierarchy levels: sociodemographic variables; reproductive history; and gestational and birth factors. Results: There were 767 cases allocated and 1,534 controls in a design of a case for two controls (1:2) by simple randomization. In the final model, a statistically significant association was found for prematurity for the following variables: mother's age under 19 years old (OR=1.32; CI 95%: 1.02-1.71) or over 34 years old (OR=1.39; CI 95%: 1.12-1.72); inadequate maternal schooling for age (OR=2.11; CI 95%: 1.22-3.65); multiple pregnancies (OR=1.14; CI 95%: 1.01-1.29); C-section (OR=1.15; CI 95%: 1.03-1.29); birth weights under 2,500g (OR=4.04; CI 95%: 3.64-4.49); Apgar score at five minutes between zero and three (OR=1.47; CI 95%: 1.12-1.91); and inadequate prenatal care (OR=1.18; CI 95%: 1.02-1.36). Conclusion: The present study showed the most immediate consequence of prematurity for newborns by evidencing its association with worse Apgar scores and low birth weight. The following factors were also shown as possible more distal determinants of prematurity: mother's age; inadequate maternal education; multiple gestation; inadequate prenatal care; and C-section.

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Section: Discussionmentioning

confidence: 99%

Maternal and neonatal factors related to prematurity

Oliveira

Gonçalves

Costa

et al. 2016

Rev. esc. enferm. USP

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“…A likely explanation to these findings could be the close relationship between gestational age and Apgar scores, as preterm infants are frequently related to low 5-min Apgar. 3,17 Higher mortality rates have been shown among preterm infants with fetal growth restriction compared to those appropriate-forgestational-age infants. 12 Similarly to the present study some investigators observed that preterm twins (<37 weeks) had lower neonatal mortality than singletons of the same gestational age, probably because twins reach an earlier fetal pulmonary maturation and also have a faster placental development.…”

Section: Discussionmentioning

confidence: 99%

Neonatal mortality in intensive care units of Central Brazil

et al. 2005

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ObjectiveTo identify potential prognostic factors for neonatal mortality among newborns referred to intensive care units. Methods A live-birth cohort study was carried out in Goiânia, Central Brazil, from November 1999 to October 2000. Linked birth and infant death certificates were used to ascertain the cohort of live born infants. An additional active surveillance system of neonatalbased mortality was implemented. Exposure variables were collected from birth and death certificates. The outcome was survivors (n=713) and deaths (n=162) in all intensive care units in the study period. Cox's proportional hazards model was applied and a Receiver Operating Characteristic curve was used to compare the performance of statistically significant variables in the multivariable model. Adjusted mortality rates by birth weight and 5-min Apgar score were calculated for each intensive care unit. Results Low birth weight and 5-min Apgar score remained independently associated to death. Birth weight equal to 2,500g had 0.71 accuracy (95% CI: 0.65-0.77) for predicting neonatal death (sensitivity =72.2%). A wide variation in the mortality rates was found among intensive care units (9.5-48.1%) and two of them remained with significant high mortality rates even after adjusting for birth weight and 5-min Apgar score. Conclusions This study corroborates birth weight as a sensitive screening variable in surveillance programs for neonatal death and also to target intensive care units with high mortality rates for implementing preventive actions and interventions during the delivery period.

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“…Dentre eles o índice de Apgar (IA) que tem a finalidade de verificar de forma rápida o estado clínico do recém-nascido e identificar, aqueles que necessitam de assistência, para avaliar os riscos e prevenir seqüelas de uma provável asfixia. [5][6][7] Ele consta de cinco parâmetros estreitamente relacionados com hipóxia perinatal: a freqüência cardíaca, a respiração, o tônus muscular, a irritabilidade reflexa e a coloração da pele do recém-nascido. Numa escala de 0 a 10 se o seu valor for menor que sete, será diagnosticada hipóxia fetal.…”

Section: Resultsunclassified