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Commentary
Maternal and child health
There is a linear association between decreasing Apgar scores at 5 and 10 min and adverse neurodevelopmental outcomes
  1. Torstein Vik1,
  2. Ragnhild Støen1,
  3. Stian Lydersen2
  1. 1 Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  2. 2 Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  1. Correspondence to Professor Torstein Vik, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim 7491, Norway; torstein.vik{at}ntnu.no

https://doi.org/10.1136/bmjebm-2018-110989

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    Commentary on: Persson M, Razaz N, Tedroff K, et al. Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden. BMJ 2018;360:k207.

    Context

    The Apgar score was originally intended to assess the condition of the newborn 1 min after birth, predict survival and to compare methods of resuscitation, various obstetric and anaesthetic practices and hospital ‘performance’.1 Assessments at 5 and 10 min were introduced later, and the association between low scores and adverse neurodevelopmental outcome is now well documented.2 Despite low positive predictive value (PPV) of low scores for adverse long-term outcome, and concerns regarding reliability and misinterpretations, the score is still in use all over the world. More recently, a 10 min score below 6 was defined as an A-criterion for cooling of newborns with neonatal encephalopathy.3 This study examined the association between 5 and 10 min Apgar scores and cerebral palsy (CP) and epilepsy, and in particular, …

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    Footnotes

    • Contributors TV was invited to write the commentary, and wrote the first and final draft. RS read the paper to be commented and provided essential knowledge, in particular regarding clinical implications, participated in the interpretation of the results, and finalising the manuscript. SL reviewed the statistical methods and participated in the interpretation of the results, and in drafting the manuscript. All authors approved the final version.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.