The continuing value of the Apgar score for the assessment of newborn infants

Research output: Contribution to journalArticle

465 Citations (Scopus)

Abstract

Background: The 10-point Apgar score has been used to assess the condition and prognosis of newborn infants throughout the world for almost 50 years. Some investigators have proposed that measurement of pH in umbilical-artery blood is a more objective method of assessing newborn infants. Methods: We carried out a retrospective cohort analysis of 151,891 live-born singleton infants without malformations who were delivered at 26 weeks of gestation or later at an inner-city public hospital between January 1988 and December 1998. Paired Apgar scores and umbilical-artery blood pH values were determined for 145,627 infants to assess which test best predicted neonatal death during the first 28 days after birth. Results: For 13,399 infants born before term (at 26 to 36 weeks of gestation), the neonatal mortality rate was 315 per 1000 for infants with five-minute Apgar scores of 0 to 3, as compared with 5 per 1000 for infants with five-minute Apgar scores of 7 to 10. For 132,228 infants born at term (37 weeks of gestation or later), the mortality rate was 244 per 1000 for infants with five-minute Apgar scores of 0 to 3, as compared with 0.2 per 1000 for infants with five-minute Apgar scores of 7 to 10. The risk of neonatal death in term infants with five-minute Apgar scores of 0 to 3 (relative risk, 1460; 95 percent confidence interval, 835 to 2555) was eight times the risk in term infants with umbilical-artery blood pH values of 7.0 or less (relative risk, 180; 95 percent confidence interval, 97 to 334). Conclusions: The Apgar scoring system remains as relevant for the prediction of neonatal survival today as it was almost 50 years ago.

Original languageEnglish (US)
Pages (from-to)467-471
Number of pages5
JournalNew England Journal of Medicine
Volume344
Issue number7
DOIs
StatePublished - Feb 15 2001

Fingerprint

Apgar Score
Newborn Infant
Umbilical Arteries
Pregnancy
Confidence Intervals
Mortality
Public Hospitals
Urban Hospitals
Infant Mortality
Cohort Studies
Research Personnel
Parturition

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The continuing value of the Apgar score for the assessment of newborn infants. / Casey, Brian M.; McIntire, Donald D.; Leveno, Kenneth J.

In: New England Journal of Medicine, Vol. 344, No. 7, 15.02.2001, p. 467-471.

Research output: Contribution to journalArticle

@article{07cb482d795e42f996b724fcc08fb8a1,
title = "The continuing value of the Apgar score for the assessment of newborn infants",
abstract = "Background: The 10-point Apgar score has been used to assess the condition and prognosis of newborn infants throughout the world for almost 50 years. Some investigators have proposed that measurement of pH in umbilical-artery blood is a more objective method of assessing newborn infants. Methods: We carried out a retrospective cohort analysis of 151,891 live-born singleton infants without malformations who were delivered at 26 weeks of gestation or later at an inner-city public hospital between January 1988 and December 1998. Paired Apgar scores and umbilical-artery blood pH values were determined for 145,627 infants to assess which test best predicted neonatal death during the first 28 days after birth. Results: For 13,399 infants born before term (at 26 to 36 weeks of gestation), the neonatal mortality rate was 315 per 1000 for infants with five-minute Apgar scores of 0 to 3, as compared with 5 per 1000 for infants with five-minute Apgar scores of 7 to 10. For 132,228 infants born at term (37 weeks of gestation or later), the mortality rate was 244 per 1000 for infants with five-minute Apgar scores of 0 to 3, as compared with 0.2 per 1000 for infants with five-minute Apgar scores of 7 to 10. The risk of neonatal death in term infants with five-minute Apgar scores of 0 to 3 (relative risk, 1460; 95 percent confidence interval, 835 to 2555) was eight times the risk in term infants with umbilical-artery blood pH values of 7.0 or less (relative risk, 180; 95 percent confidence interval, 97 to 334). Conclusions: The Apgar scoring system remains as relevant for the prediction of neonatal survival today as it was almost 50 years ago.",
author = "Casey, {Brian M.} and McIntire, {Donald D.} and Leveno, {Kenneth J.}",
year = "2001",
month = "2",
day = "15",
doi = "10.1056/NEJM200102153440701",
language = "English (US)",
volume = "344",
pages = "467--471",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "7",

}

TY - JOUR

T1 - The continuing value of the Apgar score for the assessment of newborn infants

AU - Casey, Brian M.

AU - McIntire, Donald D.

AU - Leveno, Kenneth J.

PY - 2001/2/15

Y1 - 2001/2/15

N2 - Background: The 10-point Apgar score has been used to assess the condition and prognosis of newborn infants throughout the world for almost 50 years. Some investigators have proposed that measurement of pH in umbilical-artery blood is a more objective method of assessing newborn infants. Methods: We carried out a retrospective cohort analysis of 151,891 live-born singleton infants without malformations who were delivered at 26 weeks of gestation or later at an inner-city public hospital between January 1988 and December 1998. Paired Apgar scores and umbilical-artery blood pH values were determined for 145,627 infants to assess which test best predicted neonatal death during the first 28 days after birth. Results: For 13,399 infants born before term (at 26 to 36 weeks of gestation), the neonatal mortality rate was 315 per 1000 for infants with five-minute Apgar scores of 0 to 3, as compared with 5 per 1000 for infants with five-minute Apgar scores of 7 to 10. For 132,228 infants born at term (37 weeks of gestation or later), the mortality rate was 244 per 1000 for infants with five-minute Apgar scores of 0 to 3, as compared with 0.2 per 1000 for infants with five-minute Apgar scores of 7 to 10. The risk of neonatal death in term infants with five-minute Apgar scores of 0 to 3 (relative risk, 1460; 95 percent confidence interval, 835 to 2555) was eight times the risk in term infants with umbilical-artery blood pH values of 7.0 or less (relative risk, 180; 95 percent confidence interval, 97 to 334). Conclusions: The Apgar scoring system remains as relevant for the prediction of neonatal survival today as it was almost 50 years ago.

AB - Background: The 10-point Apgar score has been used to assess the condition and prognosis of newborn infants throughout the world for almost 50 years. Some investigators have proposed that measurement of pH in umbilical-artery blood is a more objective method of assessing newborn infants. Methods: We carried out a retrospective cohort analysis of 151,891 live-born singleton infants without malformations who were delivered at 26 weeks of gestation or later at an inner-city public hospital between January 1988 and December 1998. Paired Apgar scores and umbilical-artery blood pH values were determined for 145,627 infants to assess which test best predicted neonatal death during the first 28 days after birth. Results: For 13,399 infants born before term (at 26 to 36 weeks of gestation), the neonatal mortality rate was 315 per 1000 for infants with five-minute Apgar scores of 0 to 3, as compared with 5 per 1000 for infants with five-minute Apgar scores of 7 to 10. For 132,228 infants born at term (37 weeks of gestation or later), the mortality rate was 244 per 1000 for infants with five-minute Apgar scores of 0 to 3, as compared with 0.2 per 1000 for infants with five-minute Apgar scores of 7 to 10. The risk of neonatal death in term infants with five-minute Apgar scores of 0 to 3 (relative risk, 1460; 95 percent confidence interval, 835 to 2555) was eight times the risk in term infants with umbilical-artery blood pH values of 7.0 or less (relative risk, 180; 95 percent confidence interval, 97 to 334). Conclusions: The Apgar scoring system remains as relevant for the prediction of neonatal survival today as it was almost 50 years ago.

UR - http://www.scopus.com/inward/record.url?scp=0035864977&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035864977&partnerID=8YFLogxK

U2 - 10.1056/NEJM200102153440701

DO - 10.1056/NEJM200102153440701

M3 - Article

C2 - 11172187

AN - SCOPUS:0035864977

VL - 344

SP - 467

EP - 471

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 7

ER -