Research Update: Apgar Scores Can Predict the Risk of Cerebral Palsy and Epilepsy

Shortly after birth, medical professionals assess a baby’s health using a scoring system called the Apgar scale. An Apgar score is one diagnostic method used to determine whether an infant is in need of medical intervention.

A recent publication by researchers at the Karolinksa Institutet in Sweden indicates that an infant’s Apgar score can also be used to predict the likelihood of a cerebral palsy (CP) or epilepsy diagnosis. Persson et al. (2018) conducted a population-based cohort study, including 1,213,470 infants born between 1999 and 2012. They used data on maternal and pregnancy characteristics, and diagnoses of cerebral palsy and epilepsy, as well as the infants’ Apgar scores at five and 10 minutes after birth.

In their study cohort, Persson et al. found an overall 0.1% incidence of cerebral palsy and a 0.3% incidence of epilepsy. However, children with lower Apgar scores had much a much higher likelihood of developing cerebral palsy and epilepsy. Persson et al. considered “hazard ratios,” or the probability that a child with a certain Apgar score (below 10) would receive a diagnosis compared to a child with an Apgar score of 10. They found that hazard ratios increased with decreasing Apgar scores. At the five minute Apgar assessment, the hazard ratio of cerebral palsy for children with a score of 9 was 1.9; for children with a score of 0, the hazard ratio was 277.7. They found a similar pattern when looking at the ten minute assessment. The association between Apgar score and the risk of epilepsy was not quite as precise, but they did find that infants with a five minute Apgar score of seven or less, and a 10 minute Apgar score of eight or less, were at increased risk.

Overall, this study shows an inverse relationship between Apgar scores and the likelihood that a baby will be diagnosed with cerebral palsy or epilepsy.


Persson, Martina, et al. “Five and 10 minute Apgar scores and risks of cerebral palsy and epilepsy: population based cohort study in Sweden.” BMJ 360 (2018): k207.

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