Rates of metabolic acidosis at birth and Apgar score values at 1, 5, and 10 min in term infants: a Swedish cohort study

Sven Cnattingius 1 , Stefan Johansson 1 , 2  and Neda Razaz 1
  • 1 Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
  • 2 Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
Sven Cnattingius
  • Corresponding author
  • Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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, Stefan Johansson
  • Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
  • Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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and Neda Razaz
  • Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
  • Search for other articles:
  • degruyter.comGoogle Scholar

Abstract

Background

Metabolic acidosis, measured in arterial umbilical cord blood at birth, is the most accepted definition of birth asphyxia. The aim of the study was to investigate the rates of metabolic acidosis across the entire range of Apgar score values (0–10) at 1, 5, and 10 min in term infants.

Methods

In a population-based Swedish cohort of births between 2008 and 2013, we included 85,076 term (≥37 weeks) non-malformed infants with information from umbilical arterial blood gas analyses and complete information on Apgar scores (0–10) at 1, 5, and 10 min.

Results

Rates of metabolic acidosis generally decreased with increasing Apgar score values. For Apgar score at 1 min, this decrease was consistent from Apgar score 0 (35%) to Apgar score 10 (0%). For Apgar scores at 5 and 10 min, the decrease was consistent for Apgar score values from 6 to 10.

Conclusion

Although there is a close association between Apgar score values and rates of metabolic acidosis, Apgar score is not and should not be used as a measure of birth asphyxia.

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