The Association between the Five-Minute Apgar Score and Neurodevelopmental Outcomes among Children Aged 8-66 Months in Australia.

Tahir Ahmed Hassen,Deborah Loxton,Nicholas Egan,Catherine Chojenta

doi:10.3390/ijerph18126450

Tahir Ahmed Hassen, Deborah Loxton + Show 2 more

Open Access

https://doi.org/10.3390/ijerph18126450

Copy DOI

Abstract

This study aimed to evaluate the association of the five-minute Apgar score and neurodevelopmental outcomes in children by taking the entire range of Apgar scores into account. Data from the Australian Longitudinal Study of Women’s Health (ALSWH) and Mothers and their Children’s Health (MatCH) study were linked with Australian state-based Perinatal Data Collections (PDCs) for 809 children aged 8−66 months old. Generalized estimating equations were used to model the association between the five-minute Apgar scores and neurodevelopmental outcomes, using STATA software V.15. Of the 809 children, 614 (75.3%) had a five-minute Apgar score of 9, and 130 (16.1%) had an Apgar score of 10. Approximately 1.9% and 6.2% had Apgar scores of 0−6 and 7−8, respectively. Sixty-nine (8.5%) of children had a neurodevelopmental delay. Children with an Apgar score of 0−6 (AOR = 5.7; 95% CI: 1.2, 27.8) and 7−8 (AOR = 4.1; 95% CI: 1.2, 14.1) had greater odds of gross-motor neurodevelopment delay compared to children with an Apgar score of 10. Further, when continuously modelled, the five-minute Apgar score was inversely associated with neurodevelopmental delay (AOR = 0.75; 95% CI: 0.60, 0.93). Five-minute Apgar score was independently and inversely associated with a neurodevelopmental delay, and the risks were higher even within an Apgar score of 7−8. Hence, the Apgar score may need to be taken into account when evaluating neurodevelopmental outcomes in children.

Highlights

Published: 15 June 2021Developed by Virginia Apgar in 1952, the Apgar score has been used as a rapid assessment of the clinical condition of newborns based on physiological functions, such as respiration, heart rate, skin colour, muscle tone, and reflex irritability [1]
The majority of children were born to mothers who were born in Australia (93.8%) and who were partnered (79.9%), and close to two-thirds of children were born through non-caesarean birth
7−8, com- The risk of linearly the risks of neurodevelopmental delay in both pared to those with an Apgar score of 10, significant were to notbeobserved for children neurodevelopmental delay in gross motorassociations skills was found higher among the communication delay

Summary

Introduction

Developed by Virginia Apgar in 1952, the Apgar score has been used as a rapid assessment of the clinical condition of newborns based on physiological functions, such as respiration, heart rate, skin colour, muscle tone, and reflex irritability [1]. Apgar score is measured at one minute and five minutes after birth and rated from zero to two points for each component, giving a total score that ranges from one to ten, where a higher score indicates better health and a greater chance of survival. Compared with the one-minute Apgar score, the five-minute Apgar score is a better predictor of survival [2]. The Apgar score was originally intended to assess the condition of newborns immediately after birth and to measure the response to resuscitations [3]. The Apgar score, the five-minute Apgar score, is often used in outcome studies, as it provides useful clinical information about the fetal-to-neonatal transition [4,5,6], some professional associations, such as the American Academy of Pediatrics and the American

Objectives

Methods

Results

Discussion

Conclusion