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Tytuł:
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Low Apgar score in term newborns and long-term infectious morbidity: a population-based cohort study with up to 18 years of follow-up.
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Autorzy:
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Gutbir Y; The Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. .; Ramat Gan, Israel. .
Wainstock T; Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Sheiner E; Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Segal I; Ministry of Health, Jerusalem, Israel.
Sergienko R; Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Landau D; Department of Neonatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Walfisch A; Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Źródło:
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European journal of pediatrics [Eur J Pediatr] 2020 Jun; Vol. 179 (6), pp. 959-971. Date of Electronic Publication: 2020 Feb 03.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: Berlin : Springer Verlag
Original Publication: Berlin, New York, Springer-Verlag.
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MeSH Terms:
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Apgar Score*
Hospitalization/*statistics & numerical data
Infections/*etiology
Adolescent ; Child ; Child, Preschool ; Databases, Factual ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Infections/epidemiology ; Kaplan-Meier Estimate ; Male ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors
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Contributed Indexing:
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Keywords: Child; Hospitalization; Infection; Long-term outcome; Newborn
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Entry Date(s):
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Date Created: 20200205 Date Completed: 20210302 Latest Revision: 20210302
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Update Code:
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20240105
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DOI:
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10.1007/s00431-020-03593-9
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PMID:
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32016603
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Since introduced, the Apgar score has remained the most widespread predictor for neonatal morbidity and mortality. We aimed to investigate the association between low 5-min Apgar score and long-term infectious pediatric morbidity. A population-based cohort analysis was performed comparing total and specific subtypes of infectious morbidity leading to hospitalization among term newborns with normal (≥ 7) and low (< 7) 5-min Apgar scores, born between 1999 and 2014 at a single tertiary regional hospital. Infectious morbidity included hospitalizations involving a pre-defined set of infection-related ICD-9 codes. A Kaplan-Meier survival curve was constructed to compare cumulative infectious morbidity incidence and a Cox proportional hazards model to adjust for confounders. The long-term analysis of 223,335 children (excluding perinatal death cases) yielded 585 (0.3%) infants with low 5-min Apgar scores. The rate of infection-related hospitalizations was 9.8% and 12.4% among newborns with normal and low 5-min Apgar scores, respectively (p = 0.06). Adjusting for maternal age, gestational age, hypertension, diabetes, cesarean delivery, and fertility treatments, the association proved to be statistically significant (adjusted HR = 1.28; 95% CI 1.01-1.61).Conclusion: Term infants with low 5-min Apgar scores may be at an increased risk for long-term pediatric infectious morbidity.What is Known:• Though not meant to be a prognostic tool for long-term morbidity, studies assessing the correlation between low Apgar score and long-term outcomes were and are being performed, reporting significant associations with many outcomes-such as cerebral palsy (CP), ophthalmic disorders, GI disorders, and several types of malignancies.• Yet, an association between low Apgar scores and future health remains a matter of controversy.What is New:• Our work shows that a low 5-min Apgar score is independently associated with long-term pediatric infection-related hospitalizations among term singleton newborns.
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