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Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study

Objectives To assess the association of Apgar score 5 minutes after birth with cerebral palsy in both normal weight and low birthweight children, and also the association with the cerebral palsy subdiagnoses of quadriplegia, diplegia, and hemiplegia. Design Population based cohort study. Setting The...

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Autores principales: Lie, Kari Kveim, Grøholt, Else-Karin, Eskild, Anne
Formato: Texto
Lenguaje:English
Publicado: BMJ Publishing Group Ltd. 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952090/
https://www.ncbi.nlm.nih.gov/pubmed/20929920
http://dx.doi.org/10.1136/bmj.c4990
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author Lie, Kari Kveim
Grøholt, Else-Karin
Eskild, Anne
author_facet Lie, Kari Kveim
Grøholt, Else-Karin
Eskild, Anne
author_sort Lie, Kari Kveim
collection PubMed
description Objectives To assess the association of Apgar score 5 minutes after birth with cerebral palsy in both normal weight and low birthweight children, and also the association with the cerebral palsy subdiagnoses of quadriplegia, diplegia, and hemiplegia. Design Population based cohort study. Setting The Medical Birth Registry of Norway was used to identify all babies born between 1986 and 1995. These data were linked to the Norwegian Registry of Cerebral Palsy in Children born 1986-95, which was established on the basis of discharge diagnoses at all paediatric departments in Norway. Population All singletons without malformations born in Norway during 1986-95 and who survived the first year of life (n=543 064). Main outcome measure Cerebral palsy diagnosed before the age of 5 years. Results 988 children (1.8 in 1000) were diagnosed with cerebral palsy before the age of 5 years. In total, 11% (39/369) of the children with Apgar score of less than 3 at birth were diagnosed with cerebral palsy, compared with only 0.1% (162/179 515) of the children with Apgar score of 10 (odds ratio (OR) 53, 95% CI 35 to 80 after adjustment for birth weight). In children with a birth weight of 2500 g or more, those with an Apgar score of less than 4 were much more likely to have cerebral palsy than those who had an Apgar score of more than 8 (OR 125, 95% confidence interval 91 to 170). The corresponding OR in children weighing less than 1500 g was 5 (95% CI 2 to 9). Among children with Apgar score of less than 4, 10-17% in all birthweight groups developed cerebral palsy. Low Apgar score was strongly associated with each of the three subgroups of spastic cerebral palsy, although the association was strongest for quadriplegia (adjusted OR 137 for Apgar score <4 v Apgar score >8, 95% CI 77 to 244). Conclusions Low Apgar score was strongly associated with cerebral palsy. This association was high in children with normal birth weight and modest in children with low birth weight. The strength of the association differed between subgroups of spastic cerebral palsy. Given that Apgar score is a measure of vitality shortly after birth, our findings suggest that the causes of cerebral palsy are closely linked to factors that reduce infant vitality.
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spelling pubmed-29520902010-10-12 Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study Lie, Kari Kveim Grøholt, Else-Karin Eskild, Anne BMJ Research Objectives To assess the association of Apgar score 5 minutes after birth with cerebral palsy in both normal weight and low birthweight children, and also the association with the cerebral palsy subdiagnoses of quadriplegia, diplegia, and hemiplegia. Design Population based cohort study. Setting The Medical Birth Registry of Norway was used to identify all babies born between 1986 and 1995. These data were linked to the Norwegian Registry of Cerebral Palsy in Children born 1986-95, which was established on the basis of discharge diagnoses at all paediatric departments in Norway. Population All singletons without malformations born in Norway during 1986-95 and who survived the first year of life (n=543 064). Main outcome measure Cerebral palsy diagnosed before the age of 5 years. Results 988 children (1.8 in 1000) were diagnosed with cerebral palsy before the age of 5 years. In total, 11% (39/369) of the children with Apgar score of less than 3 at birth were diagnosed with cerebral palsy, compared with only 0.1% (162/179 515) of the children with Apgar score of 10 (odds ratio (OR) 53, 95% CI 35 to 80 after adjustment for birth weight). In children with a birth weight of 2500 g or more, those with an Apgar score of less than 4 were much more likely to have cerebral palsy than those who had an Apgar score of more than 8 (OR 125, 95% confidence interval 91 to 170). The corresponding OR in children weighing less than 1500 g was 5 (95% CI 2 to 9). Among children with Apgar score of less than 4, 10-17% in all birthweight groups developed cerebral palsy. Low Apgar score was strongly associated with each of the three subgroups of spastic cerebral palsy, although the association was strongest for quadriplegia (adjusted OR 137 for Apgar score <4 v Apgar score >8, 95% CI 77 to 244). Conclusions Low Apgar score was strongly associated with cerebral palsy. This association was high in children with normal birth weight and modest in children with low birth weight. The strength of the association differed between subgroups of spastic cerebral palsy. Given that Apgar score is a measure of vitality shortly after birth, our findings suggest that the causes of cerebral palsy are closely linked to factors that reduce infant vitality. BMJ Publishing Group Ltd. 2010-10-06 /pmc/articles/PMC2952090/ /pubmed/20929920 http://dx.doi.org/10.1136/bmj.c4990 Text en © Lie et al 2010 This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Research
Lie, Kari Kveim
Grøholt, Else-Karin
Eskild, Anne
Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study
title Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study
title_full Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study
title_fullStr Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study
title_full_unstemmed Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study
title_short Association of cerebral palsy with Apgar score in low and normal birthweight infants: population based cohort study
title_sort association of cerebral palsy with apgar score in low and normal birthweight infants: population based cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952090/
https://www.ncbi.nlm.nih.gov/pubmed/20929920
http://dx.doi.org/10.1136/bmj.c4990
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