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Neonatal Morbidity Increased for Apgar Scores 7, 8, and 9

WEDNESDAY, May 8, 2019 -- Apgar scores of 7, 8, and 9 are associated with an increased risk for neonatal morbidity and mortality among term infants, according to a study published online May 7 in The BMJ.

Neda Razaz, Ph.D., from the Karolinska Institutet in Stockholm, and colleagues examined the correlations between Apgar scores of 7, 8, and 9 versus 10 at 1, 5, and 10 minutes and neonatal mortality and morbidity among 1,551,436 nonmalformed, live singleton infants born at term.

The researchers found that infants with lower Apgar scores versus an Apgar score of 10 had higher adjusted odds ratios for neonatal mortality, neonatal infections, asphyxia-related complications, respiratory distress, and neonatal hypoglycemia, especially at 5 and 10 minutes. The adjusted odds ratios for respiratory distress were 2.0, 5.2, and 12.4 for an Apgar score of 9 versus 10 at 1, 5, and 10 minutes, respectively. The adjusted rate differences for respiratory distress were 9.5 and 41.9 percent for an Apgar score of 9 and 7 versus 10, respectively, at 10 minutes. Compared with a stable Apgar score of 10 at 5 and 10 minutes, a reduction in Apgar score from 10 at 5 minutes to 9 at 10 minutes correlated with higher odds of neonatal morbidity.

"The optimal Apgar score is 10 at each time point, and all newborns should be assigned an Apgar score at 10 minutes, regardless of their score at 1 minute and 5 minutes," the authors write.

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Posted: May 2019

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