The Five-minute Apgar Score and its Association with Neurodevelopmental Disorders in 24-month-old Peruvian Children from a National Reference Hospital in Lima
Mario Chavez Hermosilla1, Claudia Cruzalegui Bazán1, Patricio Castro Suarez1, Carmen Fernández Sierra2
1Sociedad Científica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru, 2Unidad de Cuidados Intensivos Neonatales del Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
Objective:
To explore the association between the five-minute Apgar score and neurodevelopmental disorders in children from a national reference hospital in Peru.
Background:
The Apgar score is a feasible and low-cost tool for newborn health assessment applied globally and its association with other outcomes such as mortality and morbidity has been demonstrated previously. However, its value for estimating neurodevelopmental disorders is still not clear.
Design/Methods:
We conducted a retrospective cohort study with data collected from 190 Peruvian premature newborns at the Neonatology Unit of a national reference hospital during 2009 - 2014. Neurodevelopmental disorders data was obtained from surveillance visits after 24 months. Mean and standard deviation (SD) were used for descriptive analysis of quantitative variables. Odds Ratio (OR) was calculated before and after control of confounders, generalized estimating equations were used to model the association between the five-minute Apgar scores and neurodevelopmental outcomes, using RStudio 2023.06.0.
Results:
Of the 190 participants, 51.6% were male and c-section was performed in 91.6% of this sample, mean (SD) weight was 1180 (±212) grams, gestational age 29.9 (±2.33) weeks, and Apgar score 8.24 (±1.04). Statistic analysis showed that Apgar score was associated with global neurodevelopmental delay (AOR: 0.49; 95% CI: 0.29-0.80) and normal neurological assessment (AOR: 1.74; 95% CI: 1.13-2.70) asessed after 24 months.
Conclusions:
The present study found that Apgar score is a non-conclusive tool for predicting neurodevelopmental outcomes at 2-year follow up. Research is required to find an efficient instrument that helps to identify children under risk of neurodevelopmental delay. Therefore, this score could be useful to identify children at risk of these disorders; nevertheless, more research is required to control all the possible confounding variables.