Abstract
Apgar scores have been used to assess intrapartum asphyxia and to predict the association of perinatal insult with ultimate outcome. We tested the association of the one-minute Apgar Score and intrapartum asphyxia in LBW infants (n-38) by measuring umbilical artery pH and base excess (BE) from double clamped cord and by comparing infant survival with One- and Five-minute Apgar scores (n=153).
There was no correlation between Apgar score and cord pH or BE. pH varied from 6.91 to 7.55 and BE from -18 to -3 in the LBW infants with one-minute Apgar scores of 3 or less. In infants with Apgars of 4-7, pH varied from 7.13 to 7.50 and BE from -13 to -4. No consistent effect of anesthesia was apparent Survival was not predicted by cord pH or BE.
85% of LBW infants with one minute Apgars of 7 or greater survived. 46% of LBW infants with Apgars of 3 or less survived. The 5 minute Apgar score was also imprecise in predicting survival, since 25% of LBW infants with Apgars <3 survived and 14% with Apgars >7 expired.
The Apgar score is not a reliable reflection of the intrapartum condition in LBW infants and is an imprecise predictor of survival. Low Apgar scores in LBW infants should not be used, formally or informally, to decide intervention in the delivery room.
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Simmons, M., Bowes, W. & Battaglia, F. 1024 APGAR SCORES IN INFANTS LESS THAN 1500 GRAMS (LBW). Pediatr Res 12 (Suppl 4), 534 (1978). https://doi.org/10.1203/00006450-197804001-01030
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DOI: https://doi.org/10.1203/00006450-197804001-01030