April 5th, 2020

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Neonatal Outcome Following Delivery with a 1-Minute Apgar Score of 1, 2, or 3 Followed by an Apgar Score of ≥7 at 5 Minutes
Authors:  Craig V. Towers, M.D., Shelly Compton, M.D., Katie Chattin, B.S., Emily Liske, B.S., Collin Smith, B.S., and Beth Weitz, WHNP
  OBJECTIVE: To evaluate newborn outcome following delivery when the 1-minute Apgar score was 1, 2, or 3 followed by a 5-minute Apgar of ≥7.

STUDY DESIGN: We performed a retrospective evaluation of all term live births from January 2001 through December 2016. Data collection included demographics, gestational age at delivery, mode of delivery, Apgar scores, birth weight, newborn gender, intensive care unit admission, umbilical cord blood gas results, and newborn follow-up. Those with a 1-minute Apgar score of 1, 2, or 3 followed by a 5-minute score of ≥7 were analyzed.

RESULTS: From 33,039 term live births, there were 682 newborns (2.1%, 95% CI 1.9–2.2) delivered with a 1-minute Apgar score of 1, 2, or 3. Of those, 484 (1.5%, 95% CI 1.3–1.6) had a 5-minute Apgar score of ≥7 that constituted the study group. None of those neonates had any neurologic abnormalities or developmental delay identified post-delivery up to 12 months of age.

CONCLUSION: In the presence of a 5-minute Apgar score of ≥7, our data demonstrate that low 1-minute Apgar scores have no bearing on the presence of intrapartum asphyxial events.
Keywords:  Apgar score, asphyxia neonatorum, cerebral palsy, developmental delay, developmental disabilities, neonatal screening, newborn resuscitation, perinatal asphyxia
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