Comparison of the four proposed Apgar scoring systems in the assessment of birth asphyxia and adverse early neurologic outcomes

To compare the Conventional, Specified, Expanded and Combined Apgar scoring systems in predicting birth asphyxia and the adverse early neurologic outcomes. This prospective cohort study was conducted on 464 admitted neonates. In the delivery room, after delivery the umbilical cord was double clamped...

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Published in:PloS one 2015-03, Vol.10 (3), p.e0122116-e0122116
Main Authors: Dalili, Hosein, Nili, Firouzeh, Sheikh, Mahdi, Hardani, Amir Kamal, Shariat, Mamak, Nayeri, Fatemeh
Format: Article
Language:English
Subjects:
Age
Apgar Score
Asphyxia
Asphyxia Neonatorum - diagnosis
Asphyxia Neonatorum - epidemiology
Babies
Birth weight
Births
Blood
Blood Gas Analysis
Brain damage
Breastfeeding & lactation
Childbirth & labor
Committees
Comparative analysis
Encephalopathy
Gas analysis
Gestational age
Gynecology
Hemorrhage
Humans
Hypoxia
Incidence
Infant, Newborn
Ischemia
Neonates
Newborn babies
Outcome Assessment, Health Care
Pediatrics
Prevalence
Prognosis
Prospective Studies
Questionnaires
ROC Curve
Sensitivity
Sensitivity and Specificity
Ultrasound
Ultrasound imaging
Umbilical cord
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cited_by cdi_FETCH-LOGICAL-c692t-812ab94f9f6ceb64ca975d048252a2ea5745a7fee80fbae6962c02f22ffc649f3
cites cdi_FETCH-LOGICAL-c692t-812ab94f9f6ceb64ca975d048252a2ea5745a7fee80fbae6962c02f22ffc649f3
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creator Dalili, Hosein
Nili, Firouzeh
Sheikh, Mahdi
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Shariat, Mamak
Nayeri, Fatemeh
description To compare the Conventional, Specified, Expanded and Combined Apgar scoring systems in predicting birth asphyxia and the adverse early neurologic outcomes. This prospective cohort study was conducted on 464 admitted neonates. In the delivery room, after delivery the umbilical cord was double clamped and a blood samples was obtained from the umbilical artery for blood gas analysis, meanwhile on the 1- , 5- and 10- minutes Conventional, Specified, Expanded, and Combined Apgar scores were recorded. Then the neonates were followed and intracranial ultrasound imaging was performed, and the following information were recorded: the occurrence of birth asphyxia, hypoxic Ischemic Encephalopathy (HIE), intraventricular hemorrhage (IVH), and neonatal seizure. The Combined-Apgar score had the highest sensitivity (97%) and specificity (99%) in predicting birth asphyxia, followed by the Specified-Apgar score that was also highly sensitive (95%) and specific (97%). The Expanded-Apgar score was highly specific (95%) but not sensitive (67%) and the Conventional-Apgar score had the lowest sensitivity (81%) and low specificity (81%) in predicting birth asphyxia. When adjusted for gestational age, only the low 5-minute Combined-Apgar score was independently associated with the occurrence of HIE (B = 1.61, P = 0.02) and IVH (B = 2.8, P = 0.01). The newly proposed Combined-Apgar score is highly sensitive and specific in predicting birth asphyxia and also is a good predictor of the occurrence of HIE and IVH in asphyxiated neonates.
doi_str_mv 10.1371/journal.pone.0122116
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The Expanded-Apgar score was highly specific (95%) but not sensitive (67%) and the Conventional-Apgar score had the lowest sensitivity (81%) and low specificity (81%) in predicting birth asphyxia. When adjusted for gestational age, only the low 5-minute Combined-Apgar score was independently associated with the occurrence of HIE (B = 1.61, P = 0.02) and IVH (B = 2.8, P = 0.01). The newly proposed Combined-Apgar score is highly sensitive and specific in predicting birth asphyxia and also is a good predictor of the occurrence of HIE and IVH in asphyxiated neonates.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25811904</pmid><doi>10.1371/journal.pone.0122116</doi><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
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issn 1932-6203
1932-6203
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source Publicly Available Content Database; PubMed
subjects Age
Apgar Score
Asphyxia
Asphyxia Neonatorum - diagnosis
Asphyxia Neonatorum - epidemiology
Babies
Birth weight
Births
Blood
Blood Gas Analysis
Brain damage
Breastfeeding & lactation
Childbirth & labor
Committees
Comparative analysis
Encephalopathy
Gas analysis
Gestational age
Gynecology
Hemorrhage
Humans
Hypoxia
Incidence
Infant, Newborn
Ischemia
Neonates
Newborn babies
Outcome Assessment, Health Care
Pediatrics
Prevalence
Prognosis
Prospective Studies
Questionnaires
ROC Curve
Sensitivity
Sensitivity and Specificity
Ultrasound
Ultrasound imaging
Umbilical cord
title Comparison of the four proposed Apgar scoring systems in the assessment of birth asphyxia and adverse early neurologic outcomes
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