Correlation of Pulse Oximetry and Apgar Scoring in the Normal Newborns

CONTEXT: Apgar score (AS) is routinely used for assessment of newborns immediately after birth. Within acceptable limits, low saturations at birth are normal in vigorous newborn babies. Various studies have questioned the reliability of AS. AIMS: To detect whether AS is an accurate indicator of hypoxemia and to study the correlation of different components of AS with the arterial oxygenation saturation (SpO(2)) levels of normal newborns in the delivery room. SETTINGS AND DESIGN: A prospective cross-sectional observational study on normal healthy neonates delivered vaginally in a tertiary level referral medical college. MATERIALS AND METHODS: SpO(2) levels were monitored continuously in the newborns with a pulse oximeter and serial recording of SpO(2) levels was done at 5 min intervals starting at 1 min of life until 30 min after birth. Simultaneously, AS was recorded in these newborns at 1 and 5 min of life. STATISTICAL ANALYSIS: Data was analyzed using the Mann-Whitney–U test. RESULTS: AS at 1 and 5 min of life didn’t correlate with the changes in SpO(2) of newborns. In AS; though respiratory efforts and muscle tone were significantly correlated with SpO(2) of the newborns, body color did not have significant correlation with simultaneously recorded SpO(2). CONCLUSIONS: A revised AS in which evaluation of color is replaced by pulse oximetry monitoring would prove to be a better tool for neonatal evaluation in the immediate postnatal period.