Lower 5-, 10-minute Apgar scores up risk of cerebral palsy, epilepsy
There appears to be an inverse relationship between Apgar scores at 5 and 10 minutes and the risk of cerebral palsy and epilepsy, with lower scores corresponding to significantly elevated risks, a recent study has found.
Apgar scores at 5 and 10 minutes after birth were collected from 1,213,470 nonmalformed live singleton infants, of whom 0.1 percent (n=1,221) eventually developed cerebral palsy while 0.3 percent (n=3,975) developed epilepsy.
Decreasing Apgar scores at 5 minutes significantly increased the risk of cerebral palsy. Compared to a score of 10, those who scored 9 had a slight but significant increase in risk (hazard ratio [HR], 1.9; 95 percent CI, 1.6–2.2) which grew substantially in those with scores of 5 (HR, 32.6; 23.4–45.6) and 0 (HR, 277.7; 154.4–499.5).
The same trend was observed for 10-minute Apgar scores. The risk of cerebral palsy was significantly higher in those with a score of 9 vs 10 (HR, 2.4; 1.9–3.0) and escalated as the scores decreased further (HR for score of 5, 103.6; 69.8–153.7; HR for sore of 0, 237.7; 104.4–540.8).
The risk of epilepsy also decreased with increasing Apgar scores, but the trends were less clear. The risk was significantly greater in those with 5-minute scores of 0 vs 10 (HR, 11.9; 2.9–49.3), but discrepancies existed, such as lower risk associated with a score of 1 (HR, 2.6; 0.4–18.9) than with scores of 2 (HR, 4.1; 1.5–11.0) or 3 (HR, 4.4; 2.2–8.7).
The overall trend remained similar with regard to 10-minute Apgar scores. Epilepsy risk was significantly higher in those who scored 0 (HR, 11.0; 1.5–80.8), while some outliers still remain. The risk was higher in those who had a 10-minute Apgar score of 3 (HR, 15.8; 6.5–38.5).