%0 Journal Article
%T Association of Apgar score at five minutes with long-term neurologic disability and cognitive function in a prevalence study of Danish conscripts
%A Vera Ehrenstein
%A Lars Pedersen
%A Miriam Grijota
%A Gunnar Nielsen
%A Kenneth J Rothman
%A Henrik S£¿rensen
%J BMC Pregnancy and Childbirth
%D 2009
%I BioMed Central
%R 10.1186/1471-2393-9-14
%X We conducted a prevalence study among draft-liable men born in Denmark in 1978¨C1983 and presenting for the mandatory army evaluation in a northern Danish conscription district. We linked records of this evaluation, which includes medical exam and intelligence testing, with the conscripts' records in the Medical Birth Registry, containing perinatal data. We examined prevalence of neurologic disability and of low cognitive function according to five-minute Apgar score.Less than 1% (136/19,559) of the conscripts had 5-minute Apgar scores <7. Prevalence of neurologic disability was 2.2% (435/19,559) overall; among conscripts with Apgar scores <7, 7¨C9, and 10 (reference), it was 8.8%, 2.5%, and 2.2% respectively. The corresponding prevalences of low cognitive function (intelligence test score in the bottom quartile) were 34.9%, 27.2%, and 25.0%. The outcomes were more prevalent if Apgar score <7 was accompanied by certain fetal or obstetric adversities. After accounting for perinatal characteristics, 5-mintue Apgar score <7 was associated with prevalence ratios of 4.02 (95% confidence interval: 2.24; 7.24) for neurologic disability and 1.33 (0.94; 1.88) for low cognitive function.A five-minute Apgar score <7 has a consistent association with prevalence of neurologic disability and with low cognitive function in early adulthood.Apgar score [1], used to evaluate infant's condition immediately after birth, is a sum of ratings (0, 1, or 2) of five clinical signs: heart rate, respiration, reflex irritability, muscle tone, and color. Five-minute Apgar scores below 4 are strong predictors of neonatal mortality [2]. Antenatal [3,4] and peripartum [5] adversities associated with five-minute Apgar scores below 7 [6-8] have been implicated in neonatal brain injury, which in turn may lead to neurodevelopmental disability [9-13].Most newborns with Apgar scores below 7 grow up healthy, but risks of neurodevelopmental disability among them are greater than among those with higher Apgar
%U http://www.biomedcentral.com/1471-2393/9/14