Can the Apgar Score be Used for International Comparisons of Newborn Health?. Issue 4 (16th June 2017)

• Record Type: Journal Article
• Authors: Siddiqui, Ayesha; Cuttini, Marina; Wood, Rachel; Velebil, Petr; Delnord, Marie; Zile, Irisa; Barros, Henrique; Gissler, Mika; Hindori‐Mohangoo, Ashna D; Blondel, Béatrice; Zeitlin, Jennifer
• Other Names: Haidinger Gerald investigator.; Alexander Sophie investigator.; Pavlou Pavlos investigator.; Mortensen Laust investigator.; Sakkeus Luule investigator.; Lack Nicholas investigator.; Antsaklis Aris investigator.; Berbik István investigator.; Ólafsdóttir Helga Sól investigator.; Bonham Sheelagh investigator.; Misins Janis investigator.; Jaselioniene Jone investigator.; Wagener Yolande investigator.; Gatt Miriam investigator.; Nijhuis Jan investigator.; Klungsøyr Kari investigator.; Szamotulska Katarzyna investigator.; Horga Mihai investigator.; Cap Jan investigator.; Mandić Natasa Tul investigator.; Bolúmar Francisco investigator.; Gottvall Karin investigator.; Berrut Sylvie investigator.; Macfarlane Alison investigator.
• Is Part Of: Paediatric and perinatal epidemiology. Volume 31:Issue 4(2017:Jul.)
• Page Start: 338
• Page End: 345
• Publication Date: 2017-06-16
• Subjects: Apgar Score -- neonatal morbidity -- neonatal mortality -- health indicators; Pediatrics -- Periodicals; Perinatology -- Periodicals; Pediatric epidemiology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; 618.92
• DOI: 10.1111/ppe.12368
• Languages: English
• ISSNs: 0269-5022

Abstract

Abstract: Background: The Apgar score has been shown to be predictive of neonatal mortality in clinical and population studies, but has not been used for international comparisons. We examined population‐level distributions in Apgar scores and associations with neonatal mortality in Europe. Methods: Aggregate data on the 5 minute Apgar score for live births and neonatal mortality rates from countries participating in the Euro‐Peristat project in 2004 and 2010 were analysed. Country level associations between the Apgar score and neonatal mortality were assessed using the Spearman rank correlation coefficient. Results: Twenty‐three countries or regions provided data on Apgar at 5 minutes, covering 2 183 472 live births. Scores <7 ranged from 0.3% to 2.4% across countries in 2004 and 2010 and were correlated over time (ρ = 0.88, P < 0.01). There were large differences in healthy baby scores: scores of 10 ranged from 8.8% to 92.7% whereas scores of 9 or 10 ranged from 72.9% to 96.8%. Countries more likely to score 10 s, as opposed to 9 s, for healthy babies had lower proportions of Apgar <7 (ρ = −0.43, P = 0.04). Neonatal mortality rates were weakly correlated with Apgar score <7 (ρ = −0.06, P = 0.61), but differences over time in these two indicators were correlated (ρ =0.56, P = 0.02). Conclusions: Large variations in the distribution of Apgar scores likely due to national scoring practices make the Apgar score an unsuitable indicator for benchmarking newborn health across countries. However, country‐level trends over time in the Apgar score may reflect real changes and merit further investigation.