Strong association between Apgar score at 5 minutes and neonatal survival among at-risk neonates
Strong association between Apgar score at 5 minutes and neonatal survival among at-risk neonates
Abstract ObjectiveTo assess the association between 5-minutes Apgar score and neonatal survival among at-risk neonates. DesignRetrospective survival analysis. SettingEcuadorian neonates who died at ≤28 days of life. PatientsWe analyzed the nationwide neonatal deaths registered by the Ministry of Public Health of Ecuador between January 2014 to September 2017. Main outcome measuresWe performed a survival analysis and estimated adjusted hazard ratios (HR) per each 5-minutes Apgar score stratum, by Cox proportional hazards models. ResultsWe included in the study 2893 neonates, 1380 (48%) were female and had a median (P25 to P75) gestational age at birth of 31 (27 to 36) weeks. On univariate analyses, the median survival time in days of life was significantly longer per each increase in the 5-minutes Apgar score, as follows: 0.2 days for ≤4 points, 2 days for 5 points, 2.9 days for 6 points, 3.1 days for 7 points, 3.8 days for 8 points, 4.4 days for 9 points, and 5.5 days for 10 points. On multivariate analyses, and after adjusting for individual and contextual variables, and considering an Apgar score of 9 to 10 points as the reference, the HR was 32% (95% CI: 27% to 37%) higher per each decrease in the Apgar score category of two-to-three points (p-value for trend <0.01). ConclusionsThere is a strong direct association between Apgar score at 5 minutes and neonatal survival in neonates considered at-risk. This association is independent of gestational age and other neonatal determinants of neonatal mortality.
S¨￠nchez Xavier、Aguilar-Molina Andrea、Rivera-Guerra Silvana、Due?as-Esp¨an Iv¨￠n、Jimbo Ruth、Rivadeneira Mar¨aa F.、Le¨?n-C¨￠ceres ¨￠ngela、Armijos-Acurio Luciana、Aguinaga Fernando
Instituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del EcuadorInstituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del EcuadorInstituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del EcuadorInstituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del EcuadorInstituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del EcuadorInstituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del EcuadorInstituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del Ecuador||Heidelberg Institute of Global Health, Faculty of Medicine, University of Heidelberg||Tropical HerpingInstituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del EcuadorInstituto de Salud P¨2blica, Postgrado de Pediatr¨aa, Facultad de Medicina, Pontificia Universidad Cat¨?lica del Ecuador||Sociedad Ecuatoriana de Pediatr¨aa
医学研究方法儿科学
Apgar score at 5 minutesretrospective studysurvival analysisneonatal survivalat-risk neonates
S¨￠nchez Xavier,Aguilar-Molina Andrea,Rivera-Guerra Silvana,Due?as-Esp¨an Iv¨￠n,Jimbo Ruth,Rivadeneira Mar¨aa F.,Le¨?n-C¨￠ceres ¨￠ngela,Armijos-Acurio Luciana,Aguinaga Fernando.Strong association between Apgar score at 5 minutes and neonatal survival among at-risk neonates[EB/OL].(2025-03-28)[2025-08-02].https://www.medrxiv.org/content/10.1101/2020.12.04.20244319.点此复制
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