The Apgar score has been used worldwide as an index of early neonatal condition for more than 60 years. With advances in health-care service provision, neonatal resuscitation, and infant care, its present relevance is unclear. The aim of the study was to establish the strength of the relation between Apgar score at 5 min and the risk of neonatal and infant mortality, subdivided by specific causes. Complete data were available for 1 029 207 eligible livebirths.
Across all gestational strata, low Apgar score at 5 min was associated with an increased risk of neonatal and infant death. However, the strength of the association (adjusted RR, 95% CI referent to Apgar 7—10) was strongest at term (p<0·0001). A low Apgar (0—3) was associated with an adjusted RR of 359·4 (95% CI 277·3—465·9) for early neonatal death, 30·5 (18·0—51·6) for late neonatal death, and 50·2 (42·8—59·0) for infant death.…
