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Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden
OBJECTIVE: To investigate associations between Apgar score at five and 10 minutes across the entire range of score values (from 0 to 10) and risks of childhood cerebral palsy or epilepsy, and to analyse the effect of changes in Apgar scores from five to 10 minutes after birth in infants born ≥37 com...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group Ltd.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802319/ https://www.ncbi.nlm.nih.gov/pubmed/29437691 http://dx.doi.org/10.1136/bmj.k207 |
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author | Persson, Martina Razaz, Neda Tedroff, Kristina Joseph, K S Cnattingius, Sven |
author_facet | Persson, Martina Razaz, Neda Tedroff, Kristina Joseph, K S Cnattingius, Sven |
author_sort | Persson, Martina |
collection | PubMed |
description | OBJECTIVE: To investigate associations between Apgar score at five and 10 minutes across the entire range of score values (from 0 to 10) and risks of childhood cerebral palsy or epilepsy, and to analyse the effect of changes in Apgar scores from five to 10 minutes after birth in infants born ≥37 completed weeks. DESIGN, SETTING, AND PARTICIPANTS: Population based cohort study in Sweden, including 1 213 470 non-malformed live singleton infants, born at term between 1999 and 2012. Data on maternal and pregnancy characteristics and diagnoses of cerebral palsy and epilepsy were obtained by individual record linkages of nationwide Swedish registries. EXPOSURES: Apgar scores at five and 10 minutes. MAIN OUTCOME MEASURE: Cerebral palsy and epilepsy diagnosed up to 16 years of age. Adjusted hazard ratios were calculated, along with 95% confidence intervals. RESULTS: 1221 (0.1%) children were diagnosed as having cerebral palsy and 3975 (0.3%) as having epilepsy. Compared with children with an Apgar score of 10 at five minutes, the adjusted hazard ratio for cerebral palsy increased steadily with decreasing Apgar score: from 1.9 (95% confidence interval 1.6 to 2.2) for an Apgar score of 9 to 277.7 (154.4 to 499.5) for an Apgar score of 0. Similar and even stronger associations were obtained between Apgar scores at 10 minutes and cerebral palsy. Associations between Apgar scores and epilepsy were less pronounced, but increased hazard ratios were noted in infants with a five minute Apgar score of 7 or less and a 10 minute Apgar score of 8 or less. Compared with infants with an Apgar of 9-10 at both five and 10 minutes, hazard ratios of cerebral palsy and epilepsy were higher among infants with a five minute Apgar score of 7-8 and a 10 minute Apgar score of 9-10. CONCLUSION: Risks of cerebral palsy and epilepsy are inversely associated with five minute and 10 minute Apgar scores across the entire range of Apgar scores. |
format | Online Article Text |
id | pubmed-5802319 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-58023192018-02-12 Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden Persson, Martina Razaz, Neda Tedroff, Kristina Joseph, K S Cnattingius, Sven BMJ Research OBJECTIVE: To investigate associations between Apgar score at five and 10 minutes across the entire range of score values (from 0 to 10) and risks of childhood cerebral palsy or epilepsy, and to analyse the effect of changes in Apgar scores from five to 10 minutes after birth in infants born ≥37 completed weeks. DESIGN, SETTING, AND PARTICIPANTS: Population based cohort study in Sweden, including 1 213 470 non-malformed live singleton infants, born at term between 1999 and 2012. Data on maternal and pregnancy characteristics and diagnoses of cerebral palsy and epilepsy were obtained by individual record linkages of nationwide Swedish registries. EXPOSURES: Apgar scores at five and 10 minutes. MAIN OUTCOME MEASURE: Cerebral palsy and epilepsy diagnosed up to 16 years of age. Adjusted hazard ratios were calculated, along with 95% confidence intervals. RESULTS: 1221 (0.1%) children were diagnosed as having cerebral palsy and 3975 (0.3%) as having epilepsy. Compared with children with an Apgar score of 10 at five minutes, the adjusted hazard ratio for cerebral palsy increased steadily with decreasing Apgar score: from 1.9 (95% confidence interval 1.6 to 2.2) for an Apgar score of 9 to 277.7 (154.4 to 499.5) for an Apgar score of 0. Similar and even stronger associations were obtained between Apgar scores at 10 minutes and cerebral palsy. Associations between Apgar scores and epilepsy were less pronounced, but increased hazard ratios were noted in infants with a five minute Apgar score of 7 or less and a 10 minute Apgar score of 8 or less. Compared with infants with an Apgar of 9-10 at both five and 10 minutes, hazard ratios of cerebral palsy and epilepsy were higher among infants with a five minute Apgar score of 7-8 and a 10 minute Apgar score of 9-10. CONCLUSION: Risks of cerebral palsy and epilepsy are inversely associated with five minute and 10 minute Apgar scores across the entire range of Apgar scores. BMJ Publishing Group Ltd. 2018-02-08 /pmc/articles/PMC5802319/ /pubmed/29437691 http://dx.doi.org/10.1136/bmj.k207 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Research Persson, Martina Razaz, Neda Tedroff, Kristina Joseph, K S Cnattingius, Sven Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden |
title | Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden |
title_full | Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden |
title_fullStr | Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden |
title_full_unstemmed | Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden |
title_short | Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden |
title_sort | five and 10 minute apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in sweden |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802319/ https://www.ncbi.nlm.nih.gov/pubmed/29437691 http://dx.doi.org/10.1136/bmj.k207 |
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