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Low Apgar scores at both one and five minutes are associated with long‐term neurological morbidity
Author(s) -
Lein Elina,
Gissler Mika,
Haataja Leena,
Rahkonen Petri,
Andersson Sture,
Metsäranta Marjo,
Rahkonen Leena
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14234
Subject(s) - medicine , cerebral palsy , apgar score , confidence interval , logistic regression , pediatrics , population , epilepsy , odds ratio , gestational age , pregnancy , physical therapy , psychiatry , environmental health , biology , genetics
Aim This study evaluated the associations between low Apgar scores at one and five minutes and long‐term neurological impairments. Methods This study used population‐based data on 399,815 singletons born in Finland in 2004‐2010 and multivariable logistic regression to examine any associations between low (0–3) and intermediate (4–6) Apgar scores and cerebral palsy, epilepsy, intellectual disability and sensorineural defects by the age of four years. Results The odd ratios ( OR ) and 95% confidence intervals (95% CI ) showed that low Apgar scores were associated with cerebral palsy at one and five minutes ( OR s 2.08, 95% CI 1.32–3.26 and 5.19, 95% CI 3.06–8.80), epilepsy ( OR s 1.62, 95% CI 1.13–2.33 and 4.79, 95% CI 3.03–7.56), and intellectual disability ( OR s 2.46, 95% CI 1.45–4.16 and 6.21, 95% CI 3.33–11.58). Only a low five‐minute Apgar score was associated with sensorineural defects ( OR 3.13, 95% CI 1.95–5.02). Neurological impairment risks were increased by low Apgar scores at both one and five minutes ( OR 11.1, 95% CI 8.6–14.5), but 90.3% of children with persistent low Apgar scores had no impairment. Conclusion Low one‐minute and five‐minute Apgar scores were associated with long‐term neurological morbidity, especially when both scores were low.