Comparison of the Combined versus Conventional Apgar Scores in Predicting Adverse Neonatal Outcomes
Assessing the value of the Combined-Apgar score in predicting neonatal mortality and morbidity compared to the Conventional-Apgar. This prospective cohort study evaluated 942 neonates (166 very preterm, 233 near term, and 543 term) admitted to a tertiary referral hospital. At 1- and 5-minutes after...
Gespeichert in:
| Veröffentlicht in: | PloS one 2016-02, Vol.11 (2), p.e0149464-e0149464 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e0149464 |
|---|---|
| container_issue | 2 |
| container_start_page | e0149464 |
| container_title | PloS one |
| container_volume | 11 |
| creator | Dalili, Hosein Sheikh, Mahdi Hardani, Amir Kamal Nili, Firouzeh Shariat, Mamak Nayeri, Fatemeh |
| description | Assessing the value of the Combined-Apgar score in predicting neonatal mortality and morbidity compared to the Conventional-Apgar.
This prospective cohort study evaluated 942 neonates (166 very preterm, 233 near term, and 543 term) admitted to a tertiary referral hospital. At 1- and 5-minutes after delivery, the Conventional and Combined Apgar scores were recorded. The neonates were followed, and the following information was recorded: the occurrence of severe hyperbilirubinemia requiring medical intervention, the requirement for mechanical ventilation, the occurrence of intraventricular hemorrhage (IVH), and neonatal mortality.
Before adjusting for the potential confounders, a low Conventional ( |
| doi_str_mv | 10.1371/journal.pone.0149464 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1764879351</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A443115337</galeid><doaj_id>oai_doaj_org_article_aef8c919c49341e1ac74a869239f2342</doaj_id><sourcerecordid>A443115337</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-9966d8580d8f5d9d7cdb50b112e85b66b8eb8a438b20d7d7081134f6f5f96efe3</originalsourceid><addsrcrecordid>eNqNk02P0zAQhiMEYpeFf4AgEhKCQ4sdO459QaoqPiqtKGKBq-XY49SrNC52UsG_x91mVw3aA8ohyfh537HHM1n2HKM5JhV-d-2H0Kl2vvMdzBGmgjL6IDvHghQzViDy8OT7LHsS4zVCJeGMPc7OCsYrLBA_z_TSb3cquOi73Nu830CeIrXrwOR7CHGI6b_bQ9c7n7Lli12jQn6lfYCYuy7_GsA43buuyRfmIID8CySyT-x66LXfQnyaPbKqjfBsfF9kPz5--L78PLtcf1otF5czzUTRz4RgzPCSI8NtaYSptKlLVGNcAC9rxmoONVeU8LpApjIV4hgTapktrWBggVxkL4--u9ZHOdYnSlwxyitBSpyI1ZEwXl3LXXBbFf5Ir5y8CfjQSBV6p1uQCizXAgtNBaEYsNIVVTxtlAhbEFokr_djtqHegtGpREG1E9PpSuc2svF7SauyoJwlgzejQfC_Boi93LqooW1VB3642XcpMCUlSuirf9D7TzdSjUoHcJ31Ka8-mMoFpQTjkpAqUfN7qPQY2Dqdmsm6FJ8I3k4Eienhd9-oIUa5uvr2_-z655R9fcJuQLX9Jvp2OHRanIL0COrgYwxg74qMkTzMwm015GEW5DgLSfbi9ILuRLfNT_4CNhED1Q</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1764879351</pqid></control><display><type>article</type><title>Comparison of the Combined versus Conventional Apgar Scores in Predicting Adverse Neonatal Outcomes</title><source>Public Library of Science (PLoS) Journals Open Access</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Dalili, Hosein ; Sheikh, Mahdi ; Hardani, Amir Kamal ; Nili, Firouzeh ; Shariat, Mamak ; Nayeri, Fatemeh</creator><creatorcontrib>Dalili, Hosein ; Sheikh, Mahdi ; Hardani, Amir Kamal ; Nili, Firouzeh ; Shariat, Mamak ; Nayeri, Fatemeh</creatorcontrib><description>Assessing the value of the Combined-Apgar score in predicting neonatal mortality and morbidity compared to the Conventional-Apgar.
This prospective cohort study evaluated 942 neonates (166 very preterm, 233 near term, and 543 term) admitted to a tertiary referral hospital. At 1- and 5-minutes after delivery, the Conventional and Combined Apgar scores were recorded. The neonates were followed, and the following information was recorded: the occurrence of severe hyperbilirubinemia requiring medical intervention, the requirement for mechanical ventilation, the occurrence of intraventricular hemorrhage (IVH), and neonatal mortality.
Before adjusting for the potential confounders, a low Conventional (<7) or Combined (<10) Apgar score at 5-minutes was associated with adverse neonatal outcomes. However, after adjustment for the gestational age, birth weight and the requirement for neonatal resuscitation in the delivery room, a depressed 5-minute Conventional-Apgar score lost its significant associations with all the measured adverse outcomes; after the adjustments, a low 5-minute Combined-Apgar score remained significantly associated with the requirement for mechanical ventilation (OR,18.61; 95%CI,6.75-51.29), IVH (OR,4.8; 95%CI,1.91-12.01), and neonatal mortality (OR,20.22; 95%CI,4.22-96.88). Additionally, using Receiver Operating Characteristics (ROC) curves, the area under the curve was higher for the Combined-Apgar than the Conventional-Apgar for the prediction of neonatal mortality and the measured morbidities among all the admitted neonates and their gestational age subgroups.
The newly proposed Combined-Apgar score can be a good predictor of neonatal mortality and morbidity in the admitted neonates, regardless of their gestational age and resuscitation status. It is also superior to the Conventional-Apgar in predicting adverse neonatal outcomes in very preterm, near term and term neonates.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0149464</identifier><identifier>PMID: 26871908</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Apgar Score ; Area Under Curve ; Biology and Life Sciences ; Birth Weight ; Breastfeeding & lactation ; Care and treatment ; Committees ; Diagnosis ; Female ; Gestational Age ; Gynecology ; Health risk assessment ; Health screening ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Infant ; Infant Mortality ; Infant, Newborn ; Mechanical ventilation ; Medicine and Health Sciences ; Methods ; Morbidity ; Mortality ; Neonatal diseases ; Neonates ; Newborn babies ; Pediatrics ; People and Places ; Predictions ; Prospective Studies ; Respiration, Artificial ; Resuscitation ; Risk factors ; ROC Curve ; Subgroups ; Ventilation</subject><ispartof>PloS one, 2016-02, Vol.11 (2), p.e0149464-e0149464</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Dalili et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Dalili et al 2016 Dalili et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-9966d8580d8f5d9d7cdb50b112e85b66b8eb8a438b20d7d7081134f6f5f96efe3</citedby><cites>FETCH-LOGICAL-c692t-9966d8580d8f5d9d7cdb50b112e85b66b8eb8a438b20d7d7081134f6f5f96efe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752486/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752486/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26871908$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dalili, Hosein</creatorcontrib><creatorcontrib>Sheikh, Mahdi</creatorcontrib><creatorcontrib>Hardani, Amir Kamal</creatorcontrib><creatorcontrib>Nili, Firouzeh</creatorcontrib><creatorcontrib>Shariat, Mamak</creatorcontrib><creatorcontrib>Nayeri, Fatemeh</creatorcontrib><title>Comparison of the Combined versus Conventional Apgar Scores in Predicting Adverse Neonatal Outcomes</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Assessing the value of the Combined-Apgar score in predicting neonatal mortality and morbidity compared to the Conventional-Apgar.
This prospective cohort study evaluated 942 neonates (166 very preterm, 233 near term, and 543 term) admitted to a tertiary referral hospital. At 1- and 5-minutes after delivery, the Conventional and Combined Apgar scores were recorded. The neonates were followed, and the following information was recorded: the occurrence of severe hyperbilirubinemia requiring medical intervention, the requirement for mechanical ventilation, the occurrence of intraventricular hemorrhage (IVH), and neonatal mortality.
Before adjusting for the potential confounders, a low Conventional (<7) or Combined (<10) Apgar score at 5-minutes was associated with adverse neonatal outcomes. However, after adjustment for the gestational age, birth weight and the requirement for neonatal resuscitation in the delivery room, a depressed 5-minute Conventional-Apgar score lost its significant associations with all the measured adverse outcomes; after the adjustments, a low 5-minute Combined-Apgar score remained significantly associated with the requirement for mechanical ventilation (OR,18.61; 95%CI,6.75-51.29), IVH (OR,4.8; 95%CI,1.91-12.01), and neonatal mortality (OR,20.22; 95%CI,4.22-96.88). Additionally, using Receiver Operating Characteristics (ROC) curves, the area under the curve was higher for the Combined-Apgar than the Conventional-Apgar for the prediction of neonatal mortality and the measured morbidities among all the admitted neonates and their gestational age subgroups.
The newly proposed Combined-Apgar score can be a good predictor of neonatal mortality and morbidity in the admitted neonates, regardless of their gestational age and resuscitation status. It is also superior to the Conventional-Apgar in predicting adverse neonatal outcomes in very preterm, near term and term neonates.</description><subject>Age</subject><subject>Apgar Score</subject><subject>Area Under Curve</subject><subject>Biology and Life Sciences</subject><subject>Birth Weight</subject><subject>Breastfeeding & lactation</subject><subject>Care and treatment</subject><subject>Committees</subject><subject>Diagnosis</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Gynecology</subject><subject>Health risk assessment</subject><subject>Health screening</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Hyperbilirubinemia</subject><subject>Infant</subject><subject>Infant Mortality</subject><subject>Infant, Newborn</subject><subject>Mechanical ventilation</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Neonatal diseases</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Pediatrics</subject><subject>People and Places</subject><subject>Predictions</subject><subject>Prospective Studies</subject><subject>Respiration, Artificial</subject><subject>Resuscitation</subject><subject>Risk factors</subject><subject>ROC Curve</subject><subject>Subgroups</subject><subject>Ventilation</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk02P0zAQhiMEYpeFf4AgEhKCQ4sdO459QaoqPiqtKGKBq-XY49SrNC52UsG_x91mVw3aA8ohyfh537HHM1n2HKM5JhV-d-2H0Kl2vvMdzBGmgjL6IDvHghQzViDy8OT7LHsS4zVCJeGMPc7OCsYrLBA_z_TSb3cquOi73Nu830CeIrXrwOR7CHGI6b_bQ9c7n7Lli12jQn6lfYCYuy7_GsA43buuyRfmIID8CySyT-x66LXfQnyaPbKqjfBsfF9kPz5--L78PLtcf1otF5czzUTRz4RgzPCSI8NtaYSptKlLVGNcAC9rxmoONVeU8LpApjIV4hgTapktrWBggVxkL4--u9ZHOdYnSlwxyitBSpyI1ZEwXl3LXXBbFf5Ir5y8CfjQSBV6p1uQCizXAgtNBaEYsNIVVTxtlAhbEFokr_djtqHegtGpREG1E9PpSuc2svF7SauyoJwlgzejQfC_Boi93LqooW1VB3642XcpMCUlSuirf9D7TzdSjUoHcJ31Ka8-mMoFpQTjkpAqUfN7qPQY2Dqdmsm6FJ8I3k4Eienhd9-oIUa5uvr2_-z655R9fcJuQLX9Jvp2OHRanIL0COrgYwxg74qMkTzMwm015GEW5DgLSfbi9ILuRLfNT_4CNhED1Q</recordid><startdate>20160212</startdate><enddate>20160212</enddate><creator>Dalili, Hosein</creator><creator>Sheikh, Mahdi</creator><creator>Hardani, Amir Kamal</creator><creator>Nili, Firouzeh</creator><creator>Shariat, Mamak</creator><creator>Nayeri, Fatemeh</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20160212</creationdate><title>Comparison of the Combined versus Conventional Apgar Scores in Predicting Adverse Neonatal Outcomes</title><author>Dalili, Hosein ; Sheikh, Mahdi ; Hardani, Amir Kamal ; Nili, Firouzeh ; Shariat, Mamak ; Nayeri, Fatemeh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-9966d8580d8f5d9d7cdb50b112e85b66b8eb8a438b20d7d7081134f6f5f96efe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Age</topic><topic>Apgar Score</topic><topic>Area Under Curve</topic><topic>Biology and Life Sciences</topic><topic>Birth Weight</topic><topic>Breastfeeding & lactation</topic><topic>Care and treatment</topic><topic>Committees</topic><topic>Diagnosis</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Gynecology</topic><topic>Health risk assessment</topic><topic>Health screening</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Hyperbilirubinemia</topic><topic>Infant</topic><topic>Infant Mortality</topic><topic>Infant, Newborn</topic><topic>Mechanical ventilation</topic><topic>Medicine and Health Sciences</topic><topic>Methods</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Neonatal diseases</topic><topic>Neonates</topic><topic>Newborn babies</topic><topic>Pediatrics</topic><topic>People and Places</topic><topic>Predictions</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial</topic><topic>Resuscitation</topic><topic>Risk factors</topic><topic>ROC Curve</topic><topic>Subgroups</topic><topic>Ventilation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dalili, Hosein</creatorcontrib><creatorcontrib>Sheikh, Mahdi</creatorcontrib><creatorcontrib>Hardani, Amir Kamal</creatorcontrib><creatorcontrib>Nili, Firouzeh</creatorcontrib><creatorcontrib>Shariat, Mamak</creatorcontrib><creatorcontrib>Nayeri, Fatemeh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dalili, Hosein</au><au>Sheikh, Mahdi</au><au>Hardani, Amir Kamal</au><au>Nili, Firouzeh</au><au>Shariat, Mamak</au><au>Nayeri, Fatemeh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the Combined versus Conventional Apgar Scores in Predicting Adverse Neonatal Outcomes</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-02-12</date><risdate>2016</risdate><volume>11</volume><issue>2</issue><spage>e0149464</spage><epage>e0149464</epage><pages>e0149464-e0149464</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Assessing the value of the Combined-Apgar score in predicting neonatal mortality and morbidity compared to the Conventional-Apgar.
This prospective cohort study evaluated 942 neonates (166 very preterm, 233 near term, and 543 term) admitted to a tertiary referral hospital. At 1- and 5-minutes after delivery, the Conventional and Combined Apgar scores were recorded. The neonates were followed, and the following information was recorded: the occurrence of severe hyperbilirubinemia requiring medical intervention, the requirement for mechanical ventilation, the occurrence of intraventricular hemorrhage (IVH), and neonatal mortality.
Before adjusting for the potential confounders, a low Conventional (<7) or Combined (<10) Apgar score at 5-minutes was associated with adverse neonatal outcomes. However, after adjustment for the gestational age, birth weight and the requirement for neonatal resuscitation in the delivery room, a depressed 5-minute Conventional-Apgar score lost its significant associations with all the measured adverse outcomes; after the adjustments, a low 5-minute Combined-Apgar score remained significantly associated with the requirement for mechanical ventilation (OR,18.61; 95%CI,6.75-51.29), IVH (OR,4.8; 95%CI,1.91-12.01), and neonatal mortality (OR,20.22; 95%CI,4.22-96.88). Additionally, using Receiver Operating Characteristics (ROC) curves, the area under the curve was higher for the Combined-Apgar than the Conventional-Apgar for the prediction of neonatal mortality and the measured morbidities among all the admitted neonates and their gestational age subgroups.
The newly proposed Combined-Apgar score can be a good predictor of neonatal mortality and morbidity in the admitted neonates, regardless of their gestational age and resuscitation status. It is also superior to the Conventional-Apgar in predicting adverse neonatal outcomes in very preterm, near term and term neonates.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26871908</pmid><doi>10.1371/journal.pone.0149464</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2016-02, Vol.11 (2), p.e0149464-e0149464 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1764879351 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Age Apgar Score Area Under Curve Biology and Life Sciences Birth Weight Breastfeeding & lactation Care and treatment Committees Diagnosis Female Gestational Age Gynecology Health risk assessment Health screening Hemorrhage Humans Hyperbilirubinemia Infant Infant Mortality Infant, Newborn Mechanical ventilation Medicine and Health Sciences Methods Morbidity Mortality Neonatal diseases Neonates Newborn babies Pediatrics People and Places Predictions Prospective Studies Respiration, Artificial Resuscitation Risk factors ROC Curve Subgroups Ventilation |
| title | Comparison of the Combined versus Conventional Apgar Scores in Predicting Adverse Neonatal Outcomes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T02%3A54%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comparison%20of%20the%20Combined%20versus%20Conventional%20Apgar%20Scores%20in%20Predicting%20Adverse%20Neonatal%20Outcomes&rft.jtitle=PloS%20one&rft.au=Dalili,%20Hosein&rft.date=2016-02-12&rft.volume=11&rft.issue=2&rft.spage=e0149464&rft.epage=e0149464&rft.pages=e0149464-e0149464&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0149464&rft_dat=%3Cgale_plos_%3EA443115337%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1764879351&rft_id=info:pmid/26871908&rft_galeid=A443115337&rft_doaj_id=oai_doaj_org_article_aef8c919c49341e1ac74a869239f2342&rfr_iscdi=true |