ResearchObstetricsThe long-term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort
Section snippets
Methods
We searched Medline (1966-April 2005) for publications that had examined the association between low Apgar scores and neonatal outcome. The MeSH headings used were Apgar score, resuscitation, and cardiopulmonary resuscitation; the text key words searched for were Apgar, resuscitation, ten minutes, and 10 minutes. From the abstracts that were identified, we studied the eligible articles and their reference lists. Only articles that provided the outcomes of infants with an Apgar score of zero at
Results
Our literature search identified 33 studies. After we screened abstracts, we read 25 papers that were found to be relevant to this study. Eighteen papers were excluded because the outcomes of infants with an Apgar score of zero at 10 minutes could not be determined from the data. This left 7 studies in which the outcomes of infants with an Apgar score of zero at 10 minutes were known. The results of these studies combined with our results are shown in Table 1. Of the 94 infants, 88 infants
Comment
We present the unique combination of a systematic review of the literature and a prospective cohort study. Our purpose was to evaluate the outcomes of infants who were resuscitated successfully after an Apgar score of zero at 10 minutes. This issue is of great relevance to all caregivers who are involved in intrapartum care. The evidence for prolonged resuscitation has been based mainly on experimental work from the 1960s on fetal lambs.13 This showed that terminal apnea occurred 20 minutes
Acknowledgments
We thank Ms Elaine Garrett (librarian at the Royal College of Obstetricians and Gynaecologists) and Dr Mona Zaki for help in the literature search; Dr Kenny McCormack (Consultant Neonatologist), who was involved in designing the study; and Mr Lawrence Impey (Consultant in Obstetrics and Fetal Medicine) for advice in the preparation of the article.
References (14)
- et al.
Outcome after successful resuscitation of babies born with Apgar scores of 0 at both 1 and 5 minutes
Am J Obstet Gynecol
(2000) - et al.
Cardiopulmonary resuscitation of apparently stillborn infants: survival and long-term outcome
J Pediatr
(1991) - et al.
Severe asphyxia and outcome of survivors
Resuscitation
(1984) - et al.
Depressed Apgar scores, acid-base status, and neurological outcome
Am J Obstet Gynecol
(1994) - et al.
Resuscitation beyond 10 minutes of term babies born without signs of life
J Paediatr Child Health
(2004) - et al.
Outcome of resuscitation following unexpected apparent stillbirth
Arch Dis Child Fetal Neonatal Ed
(1998) - et al.
Birth asphyxia: incidence, clinical course and outcome in a Swedish population
Acta Paediatr
(1995)
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2020, ResuscitationCitation Excerpt :In this subgroup of newborns with severe depression at birth, both survival and survival without moderate-to-severe impairment have been reported. Among 105 such infants reported in the literature with Apgar scores 0 or 1 who were successfully resuscitated, were treated with therapeutic hypothermia, and were assessed after discharge, 20% of all infants survived without moderate-to-severe NDI, and 37% of the survivors did not have moderate or severe NDI.107,109–112,116,117 The evidence supporting this recommendation is of very low certainty.
Cite this article as: Harrington DJ, Redman CW, Moulden M, Greenwood CE. The long-term outcome in surviving infants with Apgar zero at 10 minutes: a systematic review of the literature and hospital-based cohort. Am J Obstet Gynecol 2007:196:463.e1-463.e5.