Comparison of the four proposed Apgar scoring systems in the assessment of birth asphyxia and adverse early neurologic outcomes.
Comparison of the four proposed Apgar scoring systems in the assessment of birth asphyxia and adverse early neurologic outcomes.
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DOI：
10.1371/journal.pone.0122116
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Nayeri F
中科院分区：
文献类型：
--
作者：
Dalili H;Nili F;Sheikh M;Hardani AK;Shariat M;Nayeri F
比较传统、指定、扩展和组合阿普加评分系统在预测出生窒息和不良早期神经系统结局方面的作用。这项前瞻性队列研究对 464 名入院新生儿进行。产房内，产后双夹脐带，从脐动脉抽取血样进行血气分析，同时记录产后1分钟、5分钟、10分钟的常规、指定、扩展和综合Apgar评分。对新生儿进行随访并进行颅内超声检查，记录出生窒息、缺氧缺血性脑病（HIE）、脑室内出血（IVH）和新生儿惊厥的发生情况。组合 Apgar 评分在预测出生窒息方面具有最高的敏感性 (97%) 和特异性 (99%)，其次是同样具有高度敏感性 (95%) 和特异性 (97%) 的 Specified-Apgar 评分。 Expanded-Apgar 评分的特异性较高（95%），但敏感性不高（67%），Conventional-Apgar 评分在预测出生窒息方面敏感性最低（81%），特异性较低（81%）。根据胎龄进行调整后，只有较低的 5 分钟综合 Apgar 评分与 HIE（B = 1.61，P = 0.02）和 IVH（B = 2.8，P = 0.01）的发生独立相关。新提出的Combined-Apgar评分对于预测出生窒息具有高度的敏感性和特异性，也是窒息新生儿发生HIE和IVH的良好预测指标。
To compare the Conventional, Specified, Expanded and Combined Apgar scoring systems in predicting birth asphyxia and the adverse early neurologic outcomes. This prospective cohort study was conducted on 464 admitted neonates. In the delivery room, after delivery the umbilical cord was double clamped and a blood samples was obtained from the umbilical artery for blood gas analysis, meanwhile on the 1- , 5- and 10- minutes Conventional, Specified, Expanded, and Combined Apgar scores were recorded. Then the neonates were followed and intracranial ultrasound imaging was performed, and the following information were recorded: the occurrence of birth asphyxia, hypoxic Ischemic Encephalopathy (HIE), intraventricular hemorrhage (IVH), and neonatal seizure. The Combined-Apgar score had the highest sensitivity (97%) and specificity (99%) in predicting birth asphyxia, followed by the Specified-Apgar score that was also highly sensitive (95%) and specific (97%). The Expanded-Apgar score was highly specific (95%) but not sensitive (67%) and the Conventional-Apgar score had the lowest sensitivity (81%) and low specificity (81%) in predicting birth asphyxia. When adjusted for gestational age, only the low 5-minute Combined-Apgar score was independently associated with the occurrence of HIE (B = 1.61, P = 0.02) and IVH (B = 2.8, P = 0.01). The newly proposed Combined-Apgar score is highly sensitive and specific in predicting birth asphyxia and also is a good predictor of the occurrence of HIE and IVH in asphyxiated neonates.
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影响因子：
2.5
作者：
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