Although its use has been criticized due to the problems of accuracy, reproducibility, and universality, the American Academy of Pediatrics and the American College of Obstetrics and Gynecology endorsed its continued use in their 2015 statement ( 3) because of its abilities to assess the need for and response to resuscitation and robust associations with the risks of infant morbidity and mortality ( 4, 5).Ī low Apgar score represents combined effects of various pre- and perinatal risk factors, which may predict non-optimal brain development ( 6– 10).
The Apgar score has been used worldwide as a vitality index for almost every newborn immediately after birth ( 1). Each item is scored from 0 to 2 with a total score of 7–10 as normal and the highest score of 10 representing the optimal condition ( 1, 2). The Apgar score is based on five components (skin color, heart rate, reflex irritability, muscle tone, and respiration). In early adulthood (19–39 years), suboptimal Apgar scores 7–9 were not associated with the risks of overall and specific mental disorders.Ĭonclusion: Infants born with clinically reassuring but suboptimal 5-min scores 7–9 are at increased risks of a wide spectrum of mental disorders in childhood. Of note, individuals with scores of 7–9 had increased risks of organic disorders (HR: 1.27, 95% CI: 1.05–1.53), neurotic disorders (HR: 1.07, 95% CI: 1.03–1.11), and a wide range of neurodevelopmental disorders, such as intellectual disability (1.87, 1.76–1.98), childhood autism (1.13, 1.05–1.22) and attention deficit hyperactivity disorder (1.10, 1.06–1.15). A dose-response association was seen even within the score range from 9 to 7 (HR 1.11, 1.14, and 1.20, respectively). In childhood (≤ 18 years), declining Apgar scores were associated with increased risks of overall mental disorders with HRs (95% CI) of 1.13(1.11-1.15), 1.34 (1.27–1.41), and 1.48 (1.31–1.67) for Apgar scores of 7–9, 4–6, and 1–3, respectively, compared with a score of 10.
The associations between suboptimal Apgar score 7–9 and mental disorders differed by attained age. Results: A total of 3,00,679 (13.6%) individuals were diagnosed with mental disorders. Methods: In a nationwide cohort study of 2,213,822 singletons born in Denmark during 1978–2015, we used cox regression to estimate the hazard ratio (HR) of mental disorders with a 95% CI. This study investigated these associations during up to 38 years of follow-up.
#Apgar score of 6 full#
Objectives: The associations of long-term risks of the full spectrum of mental disorders with clinically reassuring but suboptimal score range 7–9 remain unclear. 5Department of Public Health, Aarhus University, Aarhus, Denmark.4Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
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