1/14/2024 0 Comments Apgar score normal![]() ![]() The nationwide National Patient Register 19 20 includes diagnostic codes on hospital in-patient care since 1987 and hospital out-patient care from 2001. 18 Using the person-unique national registration numbers of mothers and infants, we linked data from the Birth Register to several national registries. The most recent extensive validation of the Medical Birth Register showed that coverage and validity of most variables were high. 17 This database contains information on antenatal, obstetrical, and neonatal care that is prospectively recorded on standardised forms for more than 98% of births in Sweden. ![]() We based our study on singleton live births in Sweden between 19, with data obtained from the Medical Birth Register. In this population based study of more than 1.5 million infants born in Sweden, we evaluated associations between Apgar scores of 7, 8, and 9 (versus 10) at 1, 5, or 10 minutes and risks of neonatal mortality and morbidity. Quantifying associations between Apgar scores in the normal range and neonatal morbidity, such as neonatal infections, neonatal respiratory distress, and hypoxic-ischaemic encephalopathy is important because such conditions are known risk factors for later neurodevelopmental adversity in children. 5 It is widely recognised that a low Apgar score, commonly defined as a score less than 7, is associated with increased risks of neonatal mortality, 6 7 morbidity, 8 9 10 and long term outcomes 11 12 13 14 15 16 however, no previous study has investigated whether Apgar scores of 7, 8, and 9 are similarly associated with higher risks of neonatal mortality and morbidity. This belief is supported by international comparisons of Apgar scores, which show that the frequency of Apgar scores of 10 at 5 minutes vary from 8.8% in some countries to 92.7% in others. The findings of differential risks associated with Apgar scores within the normal range are unexpected as it is commonly assumed that Apgar scores of 9 versus 10 are assigned arbitrarily. 2 3 4 Both the timing and the score are important: compared with an Apgar score of 10 at 5 and 10 minutes, an Apgar score of 9 at 5 minutes and an Apgar score of 9 at 10 minutes are both associated with an increased risk of cerebral palsy, with an Apgar score of 9 at 10 minutes conferring higher risk of cerebral palsy than an Apgar score of 9 at 5 minutes. 1 Our recent population based studies have shown that non-malformed term infants born with lower Apgar scores within the normal range (7 to 9) at 1, 5, or 10 minutes are at higher risk of adverse long term outcomes, such as epilepsy, cerebral palsy, having additional needs, and adverse child developmental health (compared with non-malformed term infants with an Apgar score of 10). The most routinely used measure of health status of newborns is the Apgar score, typically quantified at 1, 5, and 10 minutes after birth. ![]()
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