Low Apgar Score Linked to Cerebral Palsy

What Is the Apgar Score?

The Apgar score is a simple diagnostic process used to quickly assess a newborn baby’s general health and condition at and just after the time of birth. The Apgar score was created in 1952 by an anesthesiologist named Virginia Apgar, and since its creation, the test has been used to determine a newborn’s health and stability right after delivery in the birthing room. The Apgar score measure’s a baby’s health on five simple criteria, which include the following:

  1. Appearance / Complexion
  2. Pulse rate
  3. Grimace (reflex irritability, which measures the baby’s reaction when he or she is stimulated)
  4. Activity (muscle tone)
  5. Respiratory effort (breathing)

Each criteria is measured on a scale from zero to two, with two being the healthiest score and zero the unhealthiest. The five values are then added up to make a score from 0 to 10.

Apgar Scoring System - Diagnosing Cerebral Palsy, HIE and Birth Injuries

What Do Low Apgar Scores Indicate?

Low Apgar Score Linked to Cerebral PalsyThe Apgar test is usually given to a baby twice: once at 1 minute after birth and again at 5 minutes after birth. A baby who scores a 7 or above on the test at 1 minute after birth is generally considered in good health. A score between 4 and 6 could mean that the baby needs some help breathing or is in trouble. A score of 3 or less may mean that the baby needs more immediate lifesaving measures such as resuscitation. At 5 minutes after birth, the Apgar score is recalculated. If the baby’s score hasn’t improved to 7 or greater, the doctor and nurses will continue medical care and closely monitor the baby.

Low Apgar Scores and Cerebral Palsy

A low Apgar score may be normal for some newborns, particularly babies who are born prematurely. Sometimes perfectly healthy babies have a lower than normal score. However, during a recent study published in the British Medical Journal, researchers in Norway concluded that a low Apgar score in children born at term or with a normal birth weight is strongly associated with birth trauma and cerebral palsy (CP) in childhood.

The researchers used data from the Medical Birth Registry of Norway and the Norwegian Registry of Cerebral Palsy in Children to assess the association of an Apgar score five minutes after birth with cerebral palsy in 543,064 children born between 1986 and 1995. The prevalence of cerebral palsy in children with an Apgar score of less than 3 was more than 100 times higher than in children with a score of 10. A low Apgar score was also associated with all subgroups of spastic cerebral palsy including spastic diplegia and hemiplegia, but the association was strongest for quadriplegia. Low Apgar scores are frequently associated with birth trauma, birth injury, hypoxic ischemic encephalopthy (birth asphyxia) and traumatic birth which can cause fetal brain damage and resultant cerebral palsy.

For more information on the causes of cerebral palsy or to find out if your child’s cerebral palsy was a result of medical malpractice or birth trauma please visit this page.

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