APGAR Score
Q: My baby had a one-minute APGAR score of 1 and a five-minute APGAR score of 9. She has had frequent infections and gastric reflux for her first six months. Are these problems related to the low initial APGAR score?
Thanks,
A:
The APGAR test can be helpful in estimating the risk of future problems, but not the ones you describe. The one-minute APGAR score is a good estimate of the infant's condition when first delivered, and it sounds as though your daughter was depressed immediately after birth. However, her five-minute APGAR score was excellent. This indicates that your daughter responded to the resuscitation provided in the delivery room.
The APGAR score has been helpful in assessing newborn infants in the delivery room, but it is subject to variability from one scorer to the next. The correlation between the APGAR score (either one- or five-minute scores) and long-term outcome is weak and present only at the extremes of the score. For example, there is an increase in long-term, developmental handicaps with a very low (0-3) five-minute or later APGAR score. Infants with a five-minute APGAR score of 8-10 statistically have a lower rate of handicaps than those with a five-minute APGAR score of 0-3. However, there are infants with good APGAR scores who later have neurologic problems and many infants with low APGAR scores at five-minutes who do just fine. The APGAR score correlates with the long-term outcome in study populations, but the predictive ability of the APGAR score in a specific infant is low.
The APGAR score was originally developed by Dr. Virginia Apgar, an observant anesthesiologist. Her development of the APGAR score emphasized the importance of observation and examining the newborn infant to assess the need for resuscitation. The APGAR score continues to be of value in this regard.
I hope that this helps.
Dr. Nathan
Pediatrics
Dr. Nathan is a neonatal pediatrician with over 25 years of experience in caring for sick infants and children. He was recently selected as one of the top pediatric specialists in the Twin Cities area.
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