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Neonatal Resuscitation and Adaptation Score vs Apgar: newborn assessment and predictive ability

Journal of Perinatology volume 38, pages 1476–1482 (2018)Cite this article

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A Correction to this article was published on 19 September 2018

This article has been updated

Abstract

Objective

To test the non-inferiority of an alternative to the Apgar score.

Study design

The Neonatal Resuscitation and Adaptation Score (NRAS) was recorded in parallel to the Apgar score by a resuscitation team at deliveries. Correlation between the systems was assessed, as well as the predictive ability of NRAS and Apgar scores for mortality or short-term morbidities.

Results

A total of 340 infants were in the study group. The two scores correlated strongly (r = 0.87 and 0.83 at 1 and 5 min, respectively). Those needing ventilation at 48 h of life had a 5-min NRAS < 7 in 23/26 vs Apgar < 7 (23/36, p = 0.001). A low (0–3) 1-min NRAS score was more predictive of death, 53% vs 17%, p = 0.0065.

Conclusions

NRAS correlates with Apgar status assessment, and identifies newborns who die or may require further care better than the Apgar score.

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Change history

  • 19 September 2018

    Since the publication of the above article, the authors have noted that the name of the first Item in the NRAS scoring system in Figure 1 was omitted. It is Heart Rate (C1). The authors apologise for any inconvenience caused by this error. The html and online pdf versions have now been rectified and carry the corrected Figure.

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Authors and Affiliations

  1. Division of Neonatal Medicine, Children’s Hospital of Richmond at VCU, Richmond, VA, USA

    Teresa J. Witcher, Shadi Jurdi, Russell R. Moores Jr., Joseph Khoury & Henry J. Rozycki

  2. School of Medicine, Virginia Commonwealth University, Richmond, VA, USA

    Vidhya Kumar

  3. Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA

    Aditi Gupta

Authors
  1. Teresa J. Witcher
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  2. Shadi Jurdi
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  3. Vidhya Kumar
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  5. Russell R. Moores Jr.
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  7. Henry J. Rozycki
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Correspondence to Henry J. Rozycki.

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Witcher, T.J., Jurdi, S., Kumar, V. et al. Neonatal Resuscitation and Adaptation Score vs Apgar: newborn assessment and predictive ability. J Perinatol 38, 1476–1482 (2018). https://doi.org/10.1038/s41372-018-0189-5

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