Abstract
Comment: The authors concluded that no neonatal variable was predictive of chronic neurologic disability within me group of neonates with a complicated newborn course, further questioning the predictive abilities of both the 5-min Apgar score and the Apgar score supported by umbilical cord blood gases. The only statistically significant relationships between term infants (≥34 wk) with uncomplicated or complicated neonatal courses included 1) an Apgar score ≤3 at 5 min with complicated course and greater likelihood of delivery by cesarean section for fetal heart rate abnormalities, and 2) an Apgar score ≥3 at 5 min with complicated course and lower umbilical cord arterial pH measurements and higher base deficit values. More sophisticated, objective tests of neurodevelopmental status by cranial imaging and electrodiagnostics are needed to replace generation-old subjective measures (Apgar scores) and postnatal umbilical cord blood gases not reflective of antenatal asphyxia. Such new measures may offer greater early predictive value than existing measures of newborn well-being and neurologic outcomes.
Published Version
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