scholarly journals One-minute and five-minute Apgar scores and child developmental health at 5 years of age: a population-based cohort study in British Columbia, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027655 ◽  
Author(s):  
Neda Razaz ◽  
Sven Cnattingius ◽  
Martina Persson ◽  
Kristina Tedroff ◽  
Sarka Lisonkova ◽  
...  
Keyword(s):  
British Columbia ◽  
Special Needs ◽  
Apgar Score ◽  
Entire Range ◽  
Population Based ◽  
Term Infants ◽  
Apgar Scores ◽  
Developmental Health ◽  
Rate Ratios ◽  
Log Linear

ObjectivesWe investigated the associations between Apgar scores at 1 and 5 min, across the entire range of score values, and child developmental health at 5 years of age.SettingBritish Columbia, CanadaParticipantsAll singleton term infants without major congenital anomalies born between 1993 and 2009, who had a developmental assessment in kindergarten between 1999 and 2014.Main outcomes and measuresDevelopmental vulnerability on one or more domains of the Early Development Instrument and special needs requirements. Adjusted rate ratios (aRRs) and 95% CIs were estimated using log-linear regression.ResultsOf the 150 081 children in the study, 45 334 (30.2%) were developmentally vulnerable and 3644 (2.5%) had special needs. There was an increasing trend in developmental vulnerability and special needs with decreasing 1 min and 5 min Apgar scores. Compared with children with an Apgar score of 10 at 5 min, the aRR for developmental vulnerability increased steadily with decreasing Apgar score from 1.02 (95% CI 1.00 to 1.04) for an Apgar score of 9 to 1.57 (95% CI 1.03 to 2.39) for an Apgar score of 2. Among children with 1 min Apgar scores in the 7–10 range, changes in Apgar scores between 1 and 5 min were associated with significant differences in developmental vulnerability. Compared with children who had an Apgar score of 9 at 1 min and 10 at 5 min, children with an Apgar score of 9 at both 1 and 5 min had higher rates of developmental vulnerability (aRR 1.03, 95% CI 1.01 to 1.05). Compared with infants with an Apgar of 10 at both 1 and 5 min, infants with a 1 min score of 10 and a 5 min score of <10 had higher rates of developmental vulnerability (aRR 1.53, 95% CI 1.08 to 2.17).ConclusionRisks of adverse developmental health and having special needs at 5 years of age are inversely associated with 1 min and 5 min Apgar scores across their entire range.

scholarly journals The Association between the Five-Minute Apgar Score and Neurodevelopmental Outcomes among Children Aged 8−66 Months in Australia

2021 ◽  
Vol 18 (12) ◽  
pp. 6450
Author(s):  
Tahir Ahmed Hassen ◽  
Catherine Chojenta ◽  
Nicholas Egan ◽  
Deborah Loxton
Keyword(s):  
Apgar Score ◽  
Generalized Estimating Equations ◽  
Entire Range ◽  
Neurodevelopmental Outcomes ◽  
Apgar Scores ◽  
Neurodevelopmental Delay ◽  
Australian State ◽  
Perinatal Data ◽  
Data Collections ◽  
Minute Apgar Score

This study aimed to evaluate the association of the five-minute Apgar score and neurodevelopmental outcomes in children by taking the entire range of Apgar scores into account. Data from the Australian Longitudinal Study of Women’s Health (ALSWH) and Mothers and their Children’s Health (MatCH) study were linked with Australian state-based Perinatal Data Collections (PDCs) for 809 children aged 8−66 months old. Generalized estimating equations were used to model the association between the five-minute Apgar scores and neurodevelopmental outcomes, using STATA software V.15. Of the 809 children, 614 (75.3%) had a five-minute Apgar score of 9, and 130 (16.1%) had an Apgar score of 10. Approximately 1.9% and 6.2% had Apgar scores of 0−6 and 7−8, respectively. Sixty-nine (8.5%) of children had a neurodevelopmental delay. Children with an Apgar score of 0−6 (AOR = 5.7; 95% CI: 1.2, 27.8) and 7−8 (AOR = 4.1; 95% CI: 1.2, 14.1) had greater odds of gross-motor neurodevelopment delay compared to children with an Apgar score of 10. Further, when continuously modelled, the five-minute Apgar score was inversely associated with neurodevelopmental delay (AOR = 0.75; 95% CI: 0.60, 0.93). Five-minute Apgar score was independently and inversely associated with a neurodevelopmental delay, and the risks were higher even within an Apgar score of 7−8. Hence, the Apgar score may need to be taken into account when evaluating neurodevelopmental outcomes in children.

Earlier Apgar Score Increase in Severely Depressed Term Infants Cared for in Swedish Level III Units with 40% Oxygen Versus 100% Oxygen Resuscitation Strategies: A Population-Based Register Study

2007 ◽  
Vol 62 (5) ◽  
pp. 292-293
Author(s):  
Lena Hellstr??m-Westas ◽  
Kristina Forsblad ◽  
Gunnar Sj??rs ◽  
Ola Didrik Saugstad ◽  
Lars J. Bj??rklund ◽  
...  
Keyword(s):  
Apgar Score ◽  
Population Based ◽  
Register Study ◽  
Term Infants

The association of Apgar score with subsequent death and cerebral palsy: A population-based study in term infants

2001 ◽  
Vol 138 (6) ◽  
pp. 798-803 ◽  
Author(s):  
Dag Moster ◽  
Rolv T. Lie ◽  
Lorentz M. Irgens ◽  
Tor Bjerkedal ◽  
Trond Markestad
Keyword(s):  
Cerebral Palsy ◽  
Apgar Score ◽  
Population Based ◽  
Term Infants ◽  
Population Based Study

The Association of Apgar Score With Subsequent Death and Cerebral Palsy: A Population-Based Study in Term Infants

2002 ◽  
Vol 57 (2) ◽  
pp. 76-77
Author(s):  
Dag Moster ◽  
Rolv T. Lie ◽  
Lorentz M. Irgens ◽  
Tor Bjerkedal ◽  
Trond Markestad
Keyword(s):  
Cerebral Palsy ◽  
Apgar Score ◽  
Population Based ◽  
Term Infants ◽  
Population Based Study

Inflammatory bowel diseases among first-generation and second-generation immigrants in Denmark: a population-based cohort study

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321798
Author(s):  
Manasi Agrawal ◽  
Giulia Corn ◽  
Sarita Shrestha ◽  
Nete Munk Nielsen ◽  
Morten Frisch ◽  
...  
Keyword(s):  
Relative Risk ◽  
First Generation ◽  
Second Generation ◽  
Population Based ◽  
Country Of Birth ◽  
First Generation Immigrants ◽  
Second Generation Immigrants ◽  
Bowel Diseases ◽  
Rate Ratios ◽  
Log Linear

ObjectiveOur objective was to estimate the relative risk of IBD among first-generation and second-generation immigrants in Denmark compared with native Danes.DesignUsing national registries, we established a cohort of Danish residents between 1977 and 2018. Cohort members with known country of birth were followed for Crohn’s disease (CD) and ulcerative colitis (UC) diagnoses. Incidence rate ratios (IRRs) served as measures of relative risk and were calculated by log-linear Poisson regression, using rates among native Danes as reference, stratified by IBD risk in parental country of birth, and among first-generation immigrants by age at immigration and duration of stay in Denmark.ResultsAmong 8.7 million Danes, 4156 first-generation and 898 second-generation immigrants were diagnosed with CD or UC. Overall, comparing first-generation immigrants with native Danes, the IRR was 0.80 (95% CI 0.76 to 0.84) for CD and 0.74 (95% CI 0.71 to 0.77) for UC. The IRR of IBD increased with ≥20 years stay in Denmark. The IRR of CD increased with immigration at ≥40 years of age. Comparing second-generation immigrants with native Danes, the IRR of IBD was 0.97 (95% CI 0.91 to 1.04). There was significant interaction with sex, with higher IRR of IBD in male than in female immigrants.ConclusionRelative to native Danish men and women, IBD risk among first-generation immigrants was lower, reflected the risk in their parental country of birth and increased with ≥20 years stay in Denmark. For second-generation immigrants, relative risk of IBD was lower only among women. These complex patterns suggest the role of environmental IBD risk factors.

scholarly journals Association between Apgar scores of 7 to 9 and neonatal mortality and morbidity: population based cohort study of term infants in Sweden

BMJ ◽  
2019 ◽  
pp. l1656 ◽  
Author(s):  
Neda Razaz ◽  
Sven Cnattingius ◽  
KS Joseph
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Respiratory Distress ◽  
Neonatal Mortality ◽  
Apgar Score ◽  
Population Based ◽  
Neonatal Hypoglycaemia ◽  
Neonatal Infections ◽  
Apgar Scores ◽  
Mortality And Morbidity

Abstract Objective To investigate associations between Apgar scores of 7, 8, and 9 (versus 10) at 1, 5, and 10 minutes, and neonatal mortality and morbidity. Design Population based cohort study. Setting Sweden. Participants 1 551 436 non-malformed live singleton infants, born at term (≥37 weeks’ gestation) between 1999 and 2016, with Apgar scores of ≥7 at 1, 5, and 10 minutes. Exposures Infants with Apgar scores of 7, 8, and 9 at 1, 5, and 10 minutes were compared with those with an Apgar score of 10 at 1, 5, and 10 minutes, respectively. Main outcome measures Neonatal mortality and morbidity, including neonatal infections, asphyxia related complications, respiratory distress, and neonatal hypoglycaemia. Adjusted odds ratios (aOR), adjusted rate differences (aRD), and 95% confidence intervals were estimated. Results Compared with infants with an Apgar score of 10, aORs for neonatal mortality, neonatal infections, asphyxia related complications, respiratory distress, and neonatal hypoglycaemia were higher among infants with lower Apgar scores, especially at 5 and 10 minutes. For example, the aORs for respiratory distress for an Apgar score of 9 versus 10 were 2.0 (95% confidence interval 1.9 to 2.1) at 1 minute, 5.2 (5.1 to 5.4) at 5 minutes, and 12.4 (12.0 to 12.9) at 10 minutes. Compared with an Apgar score of 10 at 10 minutes, the aRD for respiratory distress was 9.5% (95% confidence interval 9.2% to 9.9%) for an Apgar score of 9 at 10 minutes, and 41.9% (37.7% to 46.4%) for an Apgar score of 7 at 10 minutes. A reduction in Apgar score from 10 at 5 minutes to 9 at 10 minutes was also associated with higher odds of neonatal morbidity, compared with a stable Apgar score of 10 at 5 and 10 minutes. Conclusions In term non-malformed infants with Apgar scores within the normal range (7 to 10), risks of neonatal mortality and morbidity are higher among infants with lower Apgar score values, and also among those experiencing a reduction in score from 5 minutes to 10 minutes (compared with infants with stable Apgar scores of 10).

Rates of metabolic acidosis at birth and Apgar score values at 1, 5, and 10 min in term infants: a Swedish cohort study

2020 ◽  
Vol 48 (5) ◽  
pp. 514-515 ◽  
Author(s):  
Sven Cnattingius ◽  
Stefan Johansson ◽  
Neda Razaz
Keyword(s):  
Metabolic Acidosis ◽  
Apgar Score ◽  
Close Association ◽  
Birth Asphyxia ◽  
Complete Information ◽  
Term Infants ◽  
Apgar Scores ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Swedish Cohort

AbstractBackgroundMetabolic acidosis, measured in arterial umbilical cord blood at birth, is the most accepted definition of birth asphyxia. The aim of the study was to investigate the rates of metabolic acidosis across the entire range of Apgar score values (0–10) at 1, 5, and 10 min in term infants.MethodsIn a population-based Swedish cohort of births between 2008 and 2013, we included 85,076 term (≥37 weeks) non-malformed infants with information from umbilical arterial blood gas analyses and complete information on Apgar scores (0–10) at 1, 5, and 10 min.ResultsRates of metabolic acidosis generally decreased with increasing Apgar score values. For Apgar score at 1 min, this decrease was consistent from Apgar score 0 (35%) to Apgar score 10 (0%). For Apgar scores at 5 and 10 min, the decrease was consistent for Apgar score values from 6 to 10.ConclusionAlthough there is a close association between Apgar score values and rates of metabolic acidosis, Apgar score is not and should not be used as a measure of birth asphyxia.

Earlier Apgar Score Increase in Severely Depressed Term Infants Cared for in Swedish Level III Units With 40% Oxygen Versus 100% Oxygen Resuscitation Strategies: A Population-Based Register Study

PEDIATRICS ◽  
2006 ◽  
Vol 118 (6) ◽  
pp. e1798-e1804 ◽  
Author(s):  
L. Hellstrom-Westas ◽  
K. Forsblad ◽  
G. Sjors ◽  
O. D. Saugstad ◽  
L. J. Bjorklund ◽  
...  
Keyword(s):  
Apgar Score ◽  
Population Based ◽  
Register Study ◽  
Term Infants

Apgar Score and Risk of Cerebral Palsy in Preterm Infants: A Population-Based Cohort Study

2021 ◽  
Author(s):  
Damjan Osredkar ◽  
Ivan Verdenik ◽  
Anja Troha Gergeli ◽  
Ksenija Gersak ◽  
Miha Lucovnik
Keyword(s):  
Cerebral Palsy ◽  
Preterm Infants ◽  
Apgar Score ◽  
Preterm Neonates ◽  
Adjusted Relative Risk ◽  
Term Infants ◽  
Apgar Scores ◽  
Risk Of Death ◽  
Increased Risk ◽  
Minute Apgar Score

AbstractA low Apgar score is associated with increased risk of cerebral palsy (CP) in term infants, while such association remains controversial in preterm neonates. The objective of this study was to assess association between 5-minute Apgar scores and CP in different subcategories of preterm birth based on gestational age. The Slovenian National Perinatal Information System was used to identify singleton children without congenital malformations live-born at 22 to 37 weeks of gestation between 2002 and 2010. Data were linked to the Slovenian Registry of Cerebral Palsy in children born between 2002 and 2010. CP was diagnosed at a minimum of 5 years of age. Of 11,924 children included, 241 (2.0%) died before discharge and 153 (1.3%) were diagnosed with CP. Five-minute Apgar scores <7 were significantly associated with higher risk of death or CP (compared with scores ≥9) at all preterm gestations. CP alone was associated with Apgar scores <7 only at moderately or late preterm gestation (32–36 weeks) (adjusted relative risk [aRR]: 8.27; 95% confidence interval [CI]: 1.87–36.64 for scores 0–4 and aRR: 4.96; 95% CI 1.89–13.06 for scores 5–6). In conclusion, a low 5-minute Apgar score was associated with combined outcome of neonatal death or CP in all preterm births, while in surviving preterm infants at >32 weeks a low 5-minute Apgar score was associated with CP.

scholarly journals Incidence of diabetes mellitus among people living with and without HIV in British Columbia, Canada between 2001 and 2013: a longitudinal population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e048744
Author(s):  
Andreea Bratu ◽  
Taylor McLinden ◽  
Katherine Kooij ◽  
Monica Ye ◽  
Jenny Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
British Columbia ◽  
Cohort Study ◽  
Population Based ◽  
Incidence Rates ◽  
Trend Test ◽  
People Living With Hiv ◽  
Age Related ◽  
Hiv Serostatus ◽  
The Impact

IntroductionPeople living with HIV (PLHIV) are increasingly at risk of age-related comorbidities such as diabetes mellitus (DM). While DM is associated with elevated mortality and morbidity, understanding of DM among PLHIV is limited. We assessed the incidence of DM among people living with and without HIV in British Columbia (BC), Canada, during 2001–2013.MethodsWe used longitudinal data from a population-based cohort study linking clinical data and administrative health data. We included PLHIV who were antiretroviral therapy (ART) naïve at baseline, and 1:5 age-sex-matched persons without HIV. All participants had ≥5 years of historic data pre-baseline and ≥1 year(s) of follow-up. DM was identified using the BC Ministry of Health’s definitions applied to hospitalisation, physician billing and drug dispensation datasets. Incident DM was identified using a 5-year run-in period. In addition to unadjusted incidence rates (IRs), we estimated adjusted incidence rate ratios (IRR) using Poisson regression and assessed annual trends in DM IRs per 1000 person years (PYs) between 2001 and 2013.ResultsA total of 129 PLHIV and 636 individuals without HIV developed DM over 17 529 PYs and 88,672 PYs, respectively. The unadjusted IRs of DM per 1000 PYs were 7.4 (95% CI 6.2 to 8.8) among PLHIV and 7.2 (95% CI 6.6 to 7.8) for individuals without HIV. After adjustment for confounding, HIV serostatus was not associated with DM incidence (adjusted IRR: 1.03, 95% CI 0.83 to 1.27). DM incidence did not increase over time among PLHIV (Kendall trend test: p=0.9369), but it increased among persons without HIV between 2001 and 2013 (p=0.0136).ConclusionsAfter adjustment, HIV serostatus was not associated with incidence of DM, between 2001 and 2013. Future studies should investigate the impact of ART on mitigating the potential risk of DM among PLHIV.

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