The contribution of low Apgar scores in identifying neonates with short-term morbidities in a large single center cohort

Objective: To evaluate the association and utility of low 1- and 5-min Apgar scores to identify short-term morbidities in a large newborn cohort. Methods: 15,542 infants >22 weeks gestation from a single center were included. Clinical data and low Apgar scores were analyzed for significance to ten short-term outcomes and were used to construct Receiver Operating Characteristic Curves and the AUC calculated for ten outcomes. Results: A low Apgar score related to all (1-min) or most (5-min) outcomes by univariate and multivariate logistic regression analysis. Including any of the 4 low Apgar scores only improved the clinical factor AUC by 0.9% +/- 2.7% (+/- SD) and was significant in just 5 of the 40 score/outcome scenarios. Conclusion: The contribution of a low Apgar score for identifying risk of short-term morbidity does not appear to be clinically significant.