Even slightly lower scores on the Apgar scale could predict the risk of a later diagnosis of cerebral palsy (CP) or epilepsy, new research published in The BMJ suggests.
Researchers in Sweden analysed data from the national Medical Birth Registry for over 1.2 million infants born between 1999 and 2012. Data on maternal and pregnancy characteristics and diagnoses of CP and epilepsy were obtained by individual record linkages of nationwide Swedish registries.
They found an Apgar score of 9 or lower at five or 10 minutes conferred increased risks of CP, whereas risks of epilepsy were increased among those with Apgar scores of 7-8 or less at five and 10 minutes. The authors noted that even an Apgar score of 9 at five minutes and a 10-minute score of 10 was associated with a slightly increased hazard ratio for CP, while the risk of epilepsy was increased in infants with a full Apgar score at five minutes and a 10-minute score of nine.
The authors said the findings "provide justification for assigning all newborns an Apgar score at one, five, and 10 minutes and continuing active neonatal resuscitation of infants who are mildly compromised at five minutes".