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How often is a low 5-min Apgar score in term newborns due to asphyxia?

Hogan, Linda; Ingemarsson, Ingemar LU ; Thorngren-Jerneck, Kristina LU and Herbst, Andreas LU (2007) In European Journal of Obstetrics, Gynecology, and Reproductive Biology 130(2). p.169-175
Abstract
Objective: To evaluate how often low 5-min Apgar scores (AS(5-min)) at term are associated with asphyxia. Study design: A cohort- and case-control study, including all 183 term infants with AS(5-min) below 7 born at Lund University Hospital during 1993-2002, antepartum deaths excluded. The control group included 183 randomly selected term newborns with AS(5-min) 9-10. Cardiotocography (CTG) traces were assessed blinded to group and outcome. Obstetric and pediatric files were reviewed. Results: After excluding infants with severe malformations, indications of hypoxia were found at the following rates in cases with AS(5-min) below 4 (N = 30), scores 4-6 (N = 143), and controls (N = 182)-abnormal admission CTG: 38%, 8% and 0.6%; abnormal CTG... (More)
Objective: To evaluate how often low 5-min Apgar scores (AS(5-min)) at term are associated with asphyxia. Study design: A cohort- and case-control study, including all 183 term infants with AS(5-min) below 7 born at Lund University Hospital during 1993-2002, antepartum deaths excluded. The control group included 183 randomly selected term newborns with AS(5-min) 9-10. Cardiotocography (CTG) traces were assessed blinded to group and outcome. Obstetric and pediatric files were reviewed. Results: After excluding infants with severe malformations, indications of hypoxia were found at the following rates in cases with AS(5-min) below 4 (N = 30), scores 4-6 (N = 143), and controls (N = 182)-abnormal admission CTG: 38%, 8% and 0.6%; abnormal CTG before birth: 88%, 69% and 18%; obstetrical catastrophe: 28%, 6% and 0.6%; interventions for fetal distress: 83%, 48% and 9%; cord artery pH below 7.15: 69%, 54% and 7%; hypoxic ischemic encephalopathy or hypoxic death: 70%, 14% and none. All differences between each case group and controls were statistically significant (p < 0.0001). Conclusions: In the absence of severe malformations, the vast majority of AS(5-min) below 4, and at least half of scores 4-6 could be attributed to birth asphyxia. Signs of hypoxia usually appeared during labor, but were present at admission in 38% of cases with AS(5-min) below 4. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
perinatal, neonatal, HIE, acidosis, admission test, cardiotocography, asphyxia, Apgar score, term
in
European Journal of Obstetrics, Gynecology, and Reproductive Biology
volume
130
issue
2
pages
169 - 175
publisher
Elsevier
external identifiers
  • wos:000244283600005
  • scopus:33846254634
ISSN
0301-2115
DOI
10.1016/j.ejogrb.2006.03.002
language
English
LU publication?
yes
id
d1c3f11d-83e2-4560-a7b2-68a22c382e1d (old id 155859)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16621222&dopt=Abstract
date added to LUP
2007-07-23 11:25:37
date last changed
2017-07-23 03:38:50
@article{d1c3f11d-83e2-4560-a7b2-68a22c382e1d,
  abstract     = {Objective: To evaluate how often low 5-min Apgar scores (AS(5-min)) at term are associated with asphyxia. Study design: A cohort- and case-control study, including all 183 term infants with AS(5-min) below 7 born at Lund University Hospital during 1993-2002, antepartum deaths excluded. The control group included 183 randomly selected term newborns with AS(5-min) 9-10. Cardiotocography (CTG) traces were assessed blinded to group and outcome. Obstetric and pediatric files were reviewed. Results: After excluding infants with severe malformations, indications of hypoxia were found at the following rates in cases with AS(5-min) below 4 (N = 30), scores 4-6 (N = 143), and controls (N = 182)-abnormal admission CTG: 38%, 8% and 0.6%; abnormal CTG before birth: 88%, 69% and 18%; obstetrical catastrophe: 28%, 6% and 0.6%; interventions for fetal distress: 83%, 48% and 9%; cord artery pH below 7.15: 69%, 54% and 7%; hypoxic ischemic encephalopathy or hypoxic death: 70%, 14% and none. All differences between each case group and controls were statistically significant (p &lt; 0.0001). Conclusions: In the absence of severe malformations, the vast majority of AS(5-min) below 4, and at least half of scores 4-6 could be attributed to birth asphyxia. Signs of hypoxia usually appeared during labor, but were present at admission in 38% of cases with AS(5-min) below 4.},
  author       = {Hogan, Linda and Ingemarsson, Ingemar and Thorngren-Jerneck, Kristina and Herbst, Andreas},
  issn         = {0301-2115},
  keyword      = {perinatal,neonatal,HIE,acidosis,admission test,cardiotocography,asphyxia,Apgar score,term},
  language     = {eng},
  number       = {2},
  pages        = {169--175},
  publisher    = {Elsevier},
  series       = {European Journal of Obstetrics, Gynecology, and Reproductive Biology},
  title        = {How often is a low 5-min Apgar score in term newborns due to asphyxia?},
  url          = {http://dx.doi.org/10.1016/j.ejogrb.2006.03.002},
  volume       = {130},
  year         = {2007},
}