Association between 5-min Apgar score and attention deficit hyperactivity disorder: a Scotland-wide record linkage study of 758,423 school children

Bala, Jecintha J.; Bala, Joel D.; Pell, Jill P.; Fleming, Michael

doi:10.1186/s12888-023-05217-6

Cited by 3 publications

(1 citation statement)

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“…The Apgar score at 5 min has become a widely used standardized tool for neonatal assessment and an indicator for neonates at risk for developing hypoxia–ischemia-related neonatal encephalopathy [ 2 – 4 ]. Low Apgar scores have been associated with neonatal death and long-term neurological impairment such as cerebral palsy, epilepsy, sensorineural defects, intellectual disability, and attention deficit hyperactivity disorder [ 5 – 11 ]. The 5-min Apgar score emerged as a widely accepted perinatal health indicator in national and international statistics [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Trends in Apgar scores and umbilical artery pH: a population-based cohort study on 10,696,831 live births in Germany, 2008–2022

Boos,

Bührer

2024

Eur J Pediatr

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Low Apgar scores and low umbilical arterial (UA) blood pH are considered indicators of adverse perinatal events. This study investigated trends of these perinatal health indicators in Germany. Perinatal data on 10,696,831 in-hospital live births from 2008 to 2022 were obtained from quality assurance institutes. Joinpoint regression analysis was used to quantify trends of low Apgar score and UA pH. Additional analyses stratified by mode of delivery were performed on term singletons with cephalic presentation. Robustness against unmeasured confounding was analyzed using the E-value sensitivity analysis. The overall rates of 5-min Apgar scores < 7 and UA pH < 7.10 in liveborn infants were 1.17% and 1.98%, respectively. For low Apgar scores, joinpoint analysis revealed an increase from 2008 to 2011 (annual percent change (APC) 5.19; 95% CI 3.66–9.00) followed by a slower increase from 2011 to 2019 (APC 2.56; 95% CI 2.00–3.03) and a stabilization from 2019 onwards (APC − 0.64; 95% CI − 3.60 to 0.62). The rate of UA blood pH < 7.10 increased significantly between 2011 and 2017 (APC 5.90; 95% CI 5.15–7.42). For term singletons in cephalic presentation, the risk amplification of low Apgar scores was highest after instrumental delivery (risk ratio 1.623, 95% CI 1.509–1.745), whereas those born spontaneous had the highest increase in pH < 7.10 (risk ratio 1.648, 95% CI 1.615–1.682). Conclusion: Rates of low 5-min Apgar scores and UA pH in liveborn infants increased from 2008 to 2022 in Germany. What is Known:• Low Apgar scores at 5 min after birth and umbilical arterial blood pH are associated with adverse perinatal outcomes.• Prospective collection of Apgar scores and arterial blood pH data allows for nationwide quality assurance. What is New:• The rates of liveborn infants with 5-min Apgar scores < 7 rose from 0.97 to 1.30% and that of umbilical arterial blood pH < 7.10 from 1.55 to 2.30% between 2008–2010 and 2020–2022. • In spontaneously born term singletons in cephalic presentation, the rate of metabolic acidosis with pH < 7.10 and BE < −5 mmol/L in umbilical arterial blood roughly doubled between the periods 2008–2010 and 2020–2022.

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Section: Introductionmentioning

confidence: 99%

Trends in Apgar scores and umbilical artery pH: a population-based cohort study on 10,696,831 live births in Germany, 2008–2022

Boos,

Bührer

2024

Eur J Pediatr

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Detailed Analysis of the Palmomental Reflex and Its Clinical Significance

Ma,

Zhang,

Cui

et al. 2024

Brain and Behavior

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PurposeThis comprehensive review thoroughly explores the clinical significance of the palmomental reflex (PMR) in neurological disorders. PMR is a primitive reflex that, when reemerging in adults, indicates underlying neurological dysfunction.MethodThe article elaborates on the clinical assessment techniques, neurophysiological basis, and applications of PMR in various neurological disorders, including neurodegenerative diseases, cerebrovascular disorders, traumatic brain injury, and multiple sclerosis.FindingBy understanding the modulation and suppression mechanisms of PMR, valuable insights into the specific neurological impairments associated with these disorders can be gained.ConclusionThe potential of PMR as a diagnostic marker, prognostic indicator, and treatment monitoring tool is increasingly evident.

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The dopamine hypothesis for ADHD: An evaluation of evidence accumulated from human studies and animal models

MacDonald,

Kleppe,

Szigetvari

et al. 2024

Front. Psychiatry

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Multiple lines of evidence indicate that altered dopamine signaling may be involved in neuropsychiatric disorders and common behavioral traits. Here we critically review evidence collected during the past 40-plus years supporting the role of dopamine dysfunction in attention deficit hyperactivity disorder (ADHD). We recapitulate the basic components of dopaminergic signaling in the central nervous system, focusing on core enzymes, transporters and receptors involved in monoaminergic functions, particularly in striatal and cortical regions. We summarize key human brain imaging and genetic studies reporting associations between dopaminergic neurotransmission and behavioral traits, with an emphasis on ADHD. We also consider ADHD in the context of animal models and single gene, metabolic, and neurological disorders with established dysfunction of the dopaminergic system. Examining the evidence in this way leads us to conclude that there is evidence for the involvement of dopamine but limited evidence for a hypo-dopaminergic state per se as a key component of ADHD. We propose a path forward to increase our understanding of dopamine signaling in human behavioral traits and disorders that should particularly focus on its role in clinical subgroups, during brain development and how it interacts with other neurotransmitter systems.

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Association between 5-min Apgar score and attention deficit hyperactivity disorder: a Scotland-wide record linkage study of 758,423 school children

Cited by 3 publications

References 44 publications

Trends in Apgar scores and umbilical artery pH: a population-based cohort study on 10,696,831 live births in Germany, 2008–2022

Trends in Apgar scores and umbilical artery pH: a population-based cohort study on 10,696,831 live births in Germany, 2008–2022

Detailed Analysis of the Palmomental Reflex and Its Clinical Significance

The dopamine hypothesis for ADHD: An evaluation of evidence accumulated from human studies and animal models

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