The long-term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort
Received 22 March 2006; accepted 11 October 2006.
Refers to article:
The outcome of infants with an Apgar score of zero at 10 minutes: past and future
Waldemar A. Carlo, Robert Schelonka
American Journal of Obstetrics & Gynecology
May 2007 (Vol. 196, Issue 5, Pages 422-423) Full Text |
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Objective
The purpose of this study was to investigate the outcomes of infants who had Apgar scores of zero at 10 minutes and were resuscitated successfully.
Study Design
The literature was reviewed systematically to identify the outcomes of cases; in addition, the perinatal database at the John Radcliffe Hospital, Oxford, was used to identify similar cases. Eligible infants were identified through hospital records, and outcomes of all infants with an Apgar score of zero at 10 minutes, who were born between January 1991 and December 2004, were reviewed.
Results
Eighty-five cases were identified from the literature. With the Oxford database, 9 of 83,065 infants (0.12/1000 births) met our study criteria. Six of the 9 infants died before leaving hospital. One infant with severe quadriparesis and microcephaly died at 11 months of age. One infant at follow-up examination at 5 years had severe spastic quadriparesis with severe global delay. One infant with grade 2 hypoxic-ischemic encephalopathy, who was born with severe anemia that was corrected promptly at birth, had mild disability at follow-up examination at 2 years. Thus, death or severe disability occurred in 8 of 9 infants. Combining the results of metaanalysis of published data with our results of 94 infants, 88 infants (94%) either died or were handicapped severely; 2 infants (2%) were handicapped moderately, and 1 infant (1%) was handicapped mildly. For 3 infants (3%), the long-term outcome could not be determined.
Conclusion
The outcome of infants with an Apgar score of zero at 10 minutes is almost universally poor.
1Department of Obstetrics and Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford, UK
2Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK.
Reprints: Deborah J. Harrington, MD, Department of Obstetrics and Gynaecology, Level 6, The Women’s Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK
Cite this article as: Harrington DJ, Redman CW, Moulden M, Greenwood CE. The long-term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort. Am J Obstet Gynecol 2007:196:463.e1-463.e5.
ABSTRACT