Apgar score at 10 minutes and adverse outcomes among low-risk pregnancies

Chen, Han-Yang; Chauhan, Suneet P.

doi:10.1080/14767058.2021.1943659

Cited by 7 publications

(6 citation statements)

References 33 publications

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“…A recent international cohort study including 78,126 infants also indicated that there was no significant association between gestational diabetes mellitus and hsPDA after adjusting for confounders [50]. Moreover, the independently significant association between higher Apgar scores and a lower rate of successful FIT was contrary to previous studies showing that newborn infants with lower Apgar scores had a higher risk of adverse outcomes [51,52]. This may be explained by the small sample size and confounding factors not clearly identified in our study.…”

Section: Discussioncontrasting

confidence: 99%

Association between Fluid Balance and Treatment Outcome of Ibuprofen for Patent Ductus Arteriosus in Preterm Infants

Liu¹,

Yuan²

2023

Rev. Cardiovasc. Med.

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Background: Excessive fluid intake is a predictor of the development of patent ductus arteriosus (PDA) in preterm infants. Previous studies have examined the relationship between fluid intake and outcomes following ibuprofen for PDA. However, there is a lack of data to determine whether fluid balance has an effect on ibuprofen treatment for PDA. Therefore, this study sought to determine the relationship between fluid balance and outcomes following treatment with ibuprofen for PDA. Methods: We conducted a retrospective study of 110 infants admitted to the Children's Hospital of Chongqing Medical University between January 2017 and April 2022, who were treated with ibuprofen for hemodynamically significant PDA (hsPDA). We calculated the average fluid balance before and during the two courses of ibuprofen treatment and whether they were significantly associated with outcomes in hsPDA patients. Results: In the first course of ibuprofen treatment (FIT), responders had lower fluid balance before FIT compared to non-responders [median 31.82 (18.01, 39.66) vs 34.68 (25.31, 43.56) mL/kg/day; p = 0.049], while the fluid balance during FIT [median 40.61 (33.18, 63.06) vs 42.65 (30.02, 57.96) mL/kg/day; p = 0.703] did not differ between responders and non-responders. Fluid balance before the second course of ibuprofen treatment (SIT) (mean 41.58 ± 14.26 vs 35.74 ± 10.99 mL/kg/day; p = 0.322) and during SIT (mean 39.21 ± 12.65 vs 37.00 ± 21.38 mL/kg/day; p = 0.813) was not found to have a significant association with SIT outcome. Multivariate logistic regression analysis showed fluid balance before FIT was a predictor for FIT success [Odds ratio (OR): 0.967; 95% confidence interval (CI): 0.935-0.999; p = 0.042]. Fluid balance within the first week of life had a greater association with the FIT outcome (OR: 0.967, 95% CI: 0.939-0.996, p = 0.027). Gestational diabetes mellitus and higher Apgar scores decreased the possibility of PDA closure after FIT. Conclusions: Lower fluid balance before FIT, especially within the first week of life appeared to be a predictor for closure of hsPDA after FIT in preterm infants.

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Section: Discussioncontrasting

confidence: 99%

Association between Fluid Balance and Treatment Outcome of Ibuprofen for Patent Ductus Arteriosus in Preterm Infants

Liu¹,

Yuan²

2023

Rev. Cardiovasc. Med.

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“…Initially, 1 min scores were developed as a clinical guideline for resuscitation, but recent protocols under the Neonatal Resuscitation Program have required resuscitation before 1 min, rendering a 1 min Apgar test obsolete ( 4 ). Moreover, Apgar scores at the first few minutes of life hold little long-term significance, as Apgar scores can fluctuate rapidly: even at 5 mins, neonates with “below normal” Apgar scores typically improve to reassuring Apgar scores by 10 mins ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, other studies have pointed to clinical significance for 5 and 10 mins Apgar scores where some articles showed correlations between low Apgar scores at 5 mins with increase proportions of mortality, risk of cerebral palsy, and epilepsy ( 6 ). At the same time, low scores at 10 mins are associated with a higher risk of adverse outcomes ( 32 ). This disagreement about reporting times is evident in the literature; many recent papers only report 5 mins Apgar scores, omitting 1 min scores without providing explanation for their absence ( 7 , 26 , 28 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

Validity of Apgar Score as an Indicator of Neonatal SARS-CoV-2 Infection: A Scoping Review

Chao

Menon²,

Elgendi³

2022

Front. Med.

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The coronavirus disease 2019 (COVID-19) pandemic has had profound impacts on healthcare systems worldwide, particularly regarding the care of pregnant women and their neonates. The use of the Apgar score—a discrete numerical index used to evaluate neonatal condition immediately following delivery that has been used ubiquitously as a clinical indicator of neonatal condition and widely reported in the literature for decades—has continued during the pandemic. Although health systems adopted protocols that addressed pregnant women and their neonates during the pandemic, limited research has assessed the validity of Apgar scores for determining neonatal conditions in the context of COVID-19. Therefore, this scoping review was conducted on the first 2 years of the pandemic and included mothers with reverse transcription-polymerase chain reaction confirmed COVID-19 and their resulting positive or negative neonates. In total, 1,966 articles were assessed for eligibility, yielding 246 articles describing 663 neonates. Neonates who tested negative had median Apgar scores of 9 and 9 at 1 and 5 mins, respectively, while test-positive neonates had median Apgar scores of 8 and 9 at the same time points. The proportions of test-negative neonates with Apgar scores below 7 were 29 (4%) and 11 (2%) at 1 and 5 mins, which was not statistically significant (p = 0.327, χ2 = 0.961). These proportions were even lower for positive neonates: 22 (3%) and 11 (2%) at 1 and 5 mins, respectively, which was not statistically significant (p = 1, χ2 = 0). The low proportion of Apgar scores below 7 suggests that low Apgar scores are likely to be associated with severe maternal COVID-19 symptoms during delivery rather than neonatal COVID-19. Therefore, this study indicated that Apgar scores are poor indicators of neonatal COVID-19 status.

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“…No more significant need for neonatal resuscitation is reported, and the Apgar score of the reported cases is like the normal population. In some reports, lower scores are associated with a higher incidence of preterm birth [148] , [149] , [150] , [151] .…”

Section: The Placenta Fetus and Neonatementioning

confidence: 98%

Functional consequences of SARS-CoV-2 infection in pregnant women, fetoplacental unit, and neonate

Carvajal

Casanello

Farías

et al. 2023

Biochimica et Biophysica Acta (BBA) - Molecular Basis of Diseas

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Apgar score at 10 minutes and adverse outcomes among low-risk pregnancies

Cited by 7 publications

References 33 publications

Association between Fluid Balance and Treatment Outcome of Ibuprofen for Patent Ductus Arteriosus in Preterm Infants

Association between Fluid Balance and Treatment Outcome of Ibuprofen for Patent Ductus Arteriosus in Preterm Infants

Validity of Apgar Score as an Indicator of Neonatal SARS-CoV-2 Infection: A Scoping Review

Functional consequences of SARS-CoV-2 infection in pregnant women, fetoplacental unit, and neonate

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