| Title: |
Apgar Score Plus Umbilical Artery pH and Adverse Neonatal Outcomes in Very Preterm Infants |
| Authors: |
Ehrhardt, Harald; Behboodi, Soodabeh; Maier, Rolf F.; Aubert, Adrien M.; Ådén, Ulrika; Staude, Birte; Draper, Elizabeth S.; Gudmundsdottir, Anna; Siljehav, Veronica; Varendi, Heili; Weber, Tom; Zemlin, Michael; Zeitlin, Jennifer; Lebeer, Jo; van Reempts, Patrick; Bruneel, Els; Cloet, Eva; Oostra, Ann; Ortibus, Els; Sarrechia, Iemke; Boerch, Klaus; Huusom, Lene; Pedersen, Pernille; Hasselager, Asbjørn; Toome, Liis; Männamaa, Mairi; Ancel, Pierre-Yves; Burguet, Antoine; Jarreau, Pierre; Pierrat, Véronique; Truffert, Patrick; Misselwitz, Björn; Schmidt, Stephan; Wohlers, Lena; Cuttini, Maria; Di Lallo, Domenico; Ancora, Gina; Baronciani, Dante; Carnielli, Virgilio; Croci, Ileana; Faldella, Giacomo; Ferrari, Frederica; Franco, Francesco; Gargano, Giancarlo; Koopman-Esseboom, Corine; Gadzinowski, Janusz; Mazela, Jan; Montgomery, Alan; Pikuła, Tomasz; Barros, Henrique |
| Source: |
JAMA Network Open ; volume 9, issue 2, page e2557913 ; ISSN 2574-3805 |
| Publisher Information: |
American Medical Association (AMA) |
| Publication Year: |
2026 |
| Description: |
Importance The Apgar score, the first clinical assessment to direct measures to stabilize newborn infants, is also used for risk assessment. Its accuracy in estimating outcomes remains poor among very preterm (VPT) infants. Objective To assess the utility of the combined 5-minute Apgar score and umbilical artery pH (UA-pH) for estimating risks of mortality and severe neonatal morbidity among VPT infants. Design, Setting, and Participants This cohort study (Effective Perinatal Intensive Care in Europe [EPICE]) analyzed infants born at less than 32 weeks’ gestation between April 2011 and September 2012 across 11 European countries. All liveborn VPT infants with Apgar scores and UA-pH data were included. Data were analyzed between February and December 2025. Exposures Apgar score at 5 minutes and UA-pH. The Apgar score was classified as lower than 7 and 7 or higher, and the UA-pH values were categorized as low (grade 2, cystic periventricular leukomalacia, moderate or severe bronchopulmonary dysplasia [BPD], retinopathy of prematurity ≥stage 2, and necrotizing enterocolitis). Modified Poisson regression was used to estimate relative risks (RRs) between the exposure and the combined mortality and morbidity outcome and 3 individual components: mortality, IVH, and BPD. Models were adjusted for perinatal variables associated with Apgar score and UA-pH and adverse neonatal outcomes. Results Of 7900 liveborn infants in the EPICE cohort, 4174 (52.8%) had information on Apgar score and UA-pH. These infants included 2249 males (53.9%) and had a median [IQR] gestational age of 29.9 [27.9-31.0] weeks and median [IQR] birth weight of 1240 ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1001/jamanetworkopen.2025.57913 |
| Availability: |
https://doi.org/10.1001/jamanetworkopen.2025.57913; https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2844714/ehrhardt_2026_oi_251540_1769708100.26589.pdf |
| Accession Number: |
edsbas.C4E51B22 |
| Database: |
BASE |