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Rüdiger, M; Braun, N; Aranda, J; Aguar, M; Bergert, R; Bystricka, A; Dimitriou, G; El-Atawi, K; Ifflaender, S; Jung, P; Matasova, K; Ojinaga, V; Petruskeviciene, Z; Roll, C; Schwindt, J; Simma, B; Staal, N; Valencia, G; Vasconcellos, MG; Veinla, M; Vento, M; Weber, B; Wendt, A; Yigit, S; Zotter, H; Küster, H; TEST-Apgar Study-Group.
Neonatal assessment in the delivery room--Trial to Evaluate a Specified Type of Apgar (TEST-Apgar).
BMC Pediatr. 2015; 15(5):18-18
Doi: 10.1186/s12887-015-0334-7
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- Co-Autor*innen der Med Uni Graz
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Zotter Heinz
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- Abstract:
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Since an objective description is essential to determine infant's postnatal condition and efficacy of interventions, two scores were suggested in the past but weren't tested yet: The Specified-Apgar uses the 5 items of the conventional Apgar score; however describes the condition regardless of gestational age (GA) or resuscitative interventions. The Expanded-Apgar measures interventions needed to achieve this condition. We hypothesized that the combination of both (Combined-Apgar) describes postnatal condition of preterm infants better than either of the scores alone.
Scores were assessed in preterm infants below 32 completed weeks of gestation. Data were prospectively collected in 20 NICU in 12 countries. Prediction of poor outcome (death, severe/moderate BPD, IVH, CPL and ROP) was used as a surrogate parameter to compare the scores. To compare predictive value the AUC for the ROC was calculated.
Of 2150 eligible newborns, data on 1855 infants with a mean GA of 28(6/7) ± 2(3/7) weeks were analyzed. At 1 minute, the Combined-Apgar was significantly better in predicting poor outcome than the Specified- or Expanded-Apgar alone. Of infants with a very low score at 5 or 10 minutes 81% or 100% had a poor outcome, respectively. In these infants the relative risk (RR) for perinatal mortality was 24.93 (13.16-47.20) and 31.34 (15.91-61.71), respectively.
The Combined-Apgar allows a more appropriate description of infant's condition under conditions of modern neonatal care. It should be used as a tool for better comparison of group of infants and postnatal interventions.
clinicaltrials.gov Protocol Registration System (NCT00623038). Registered 14 February 2008.
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Apgar Score -
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Delivery Rooms -
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Female -
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Gestational Age -
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Humans -
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Infant -
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Infant Mortality -
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Infant, Newborn -
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Infant, Premature -
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Pregnancy -
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Prognosis -
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Risk Factors -
- Find related publications in this database (Keywords)
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Apgar score
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Expanded-Apgar
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Specified-Apgar
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Postnatal condition
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Neonatal assessment
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Delivery room management
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Preterm resuscitation