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Pournajaf S, Akbarian-Rad Z, Bozorgnezhad N, Gholinia Ahangar H, Haghshenas M. Diagnostic Value of Combined and Conventional Apgar Scoring System in Identifying Poor Short-Term Outcomes in Infants. CJP 2024; 10
URL: http://caspianjp.ir/article-1-238-en.html
URL: http://caspianjp.ir/article-1-238-en.html
Samira Pournajaf 
, Zahra Akbarian-Rad , Nesae Bozorgnezhad , Hemmat Gholinia Ahangar , Mohsen Haghshenas
, Zahra Akbarian-Rad , Nesae Bozorgnezhad , Hemmat Gholinia Ahangar , Mohsen Haghshenas
Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IR Iran , Matia.mojaveri@yahoo.com
Abstract: (266 Views)
Background and Objective: Clinical assessment of newborns in the first minutes after birth is a challenge in neonatal medicine. The aim of this study was to compare the diagnostic value of the combined and conventional Apgar scoring systems in identifying poor short-term outcomes in newborns
Methods: This prospective cohort study evaluated 660 newborns at Ayatollah Rouhani Hospital of Babol-Iran (a tertiary referral hospital), from October 2021 to November 2022. After birth, the 5th-minute conventional and combined Apgar scores were recorded. the newborns were followed. The area under the receiver operating characteristic (ROC) curve (AUC) was used to determine the sensitivity and specificity of the Apgar scores to predict short-term outcomes (mechanical ventilation requirement, occurrence of intraventricular hemorrhage, neonatal mortality, and retinopathy of prematurity).
Findings: Out of 660 newborns 373 (56.5%) males and 287 (43.5%) females), Fifty-seven (8.6%) newborns had IVH, 46 (6.97%), were diagnosed with ROP, 40 (6.1%) newborns required mechanical ventilation, and 41 (6.21%) died. The AUC of combined Apgar for predicting ROP and IVH (82% and 76% respectively) and the AUC of conventional Apgar for predicting death and mechanical ventilation (90% and 85% respectively) was higher than the others.
Conclusion: The conventional Apgar score was better than the combined Apgar score for predicting mechanical ventilation requirement and death. When infants were grouped by gestational age, none of theApgar scores was a good predictor of ROP. Also, Apgar was only a good predictor of IVH at gestational ages greater than 34 weeks, of which combined Apgar is better than the others.
Methods: This prospective cohort study evaluated 660 newborns at Ayatollah Rouhani Hospital of Babol-Iran (a tertiary referral hospital), from October 2021 to November 2022. After birth, the 5th-minute conventional and combined Apgar scores were recorded. the newborns were followed. The area under the receiver operating characteristic (ROC) curve (AUC) was used to determine the sensitivity and specificity of the Apgar scores to predict short-term outcomes (mechanical ventilation requirement, occurrence of intraventricular hemorrhage, neonatal mortality, and retinopathy of prematurity).
Findings: Out of 660 newborns 373 (56.5%) males and 287 (43.5%) females), Fifty-seven (8.6%) newborns had IVH, 46 (6.97%), were diagnosed with ROP, 40 (6.1%) newborns required mechanical ventilation, and 41 (6.21%) died. The AUC of combined Apgar for predicting ROP and IVH (82% and 76% respectively) and the AUC of conventional Apgar for predicting death and mechanical ventilation (90% and 85% respectively) was higher than the others.
Conclusion: The conventional Apgar score was better than the combined Apgar score for predicting mechanical ventilation requirement and death. When infants were grouped by gestational age, none of theApgar scores was a good predictor of ROP. Also, Apgar was only a good predictor of IVH at gestational ages greater than 34 weeks, of which combined Apgar is better than the others.
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