Objective. ?The Apgar score is well-characterized in full-term infants but not in premature infants. The objective of this study was to assess the Apgar score in preterm infants with respect to the relationships between the 1- and 5-minute scores, the correlation of the Apgar score with pH and with other variables, and the relationship among the individual Apgar components.Methodology. ?We recorded Apgar scores at 1 and 5 minutes in a population-based cohort of preterm infants (n = 1105) with birth weight 2000 g, from three intensive care nurseries in central New Jersey. Linear correlation analysis was used to examine the relationship between 1- and 5-minute Apgar scores and between the individual components of the Apgar score. Multiple regression analysis was used to explore the relationship between various perinatal characteristics and the Apgar score, and between pH and Apgar score. Stepwise logistic regression analysis was used to assess the determinants of mortality.Results. ?The 1-minute Apgar score median (25%, 75%) was 6(4,8) and correlated with the 5-minute score of 8(7,9) at r = .78. Slight but significant differences were seen between male (n = 557) and female (n = 508) infants in the 1-minute (6[4,8] and 7[4,8]) Apgar scores. One- and 5-minute scores of white infants (7[4,8] and 8[7,9]; n = 713) were significantly higher than those of black infants (5[3,7] and 8[6,9]; n = 280). Birth weight and gestational age were both linearly related to both Apgar scores. Low Apgar score (3 at 1 minute and 6 at 5 minutes) was significantly associated with birth weight, gestational age and mode of delivery. Low arterial blood pH (7.01) at birth was significantly related to low Apgar score. One hundred fifty-nine infants died; these infants were significantly smaller (983 ± 382 vs 1462 ± 369 g), less mature (27 vs 31 weeks), had lower arterial blood pH (7.20 ± 0.18 vs 7.31 ± 0.11), had lower 1- (3[2,6] vs 7[4,8]) and 5-minute Apgar scores (6[4,8] vs 8[7,9]), and a greater incidence of low Apgar score (32% vs 6%) than did survivors.Conclusions. ?Among the components of the Apgar score, respiratory effort, muscle tone, and reflex activity correlated well with one another; heart rate correlated less well; and color the least. Our data confirms the limited use of the Apgar score in preterm infants and demonstrates the different responses of the Apgar score's components.
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机译：目的。 ？Apgar评分在足月婴儿中具有很好的特征，但在早产儿中却没有。这项研究的目的是评估1分钟和5分钟评分之间的关系，Apgar评分与pH值和其他变量之间的关系以及各个Apgar成分之间的关系，评估早产儿的Apgar评分。方法。我们在新泽西州中部的三个重症监护托儿所中，对出生体重<2000 g的以人口为基础的早产儿（n = 1105）进行了记录，分别记录了1分钟和5分钟时的Apgar评分。线性相关分析用于检查1分钟和5分钟的Apgar评分之间以及Apgar评分的各个组成部分之间的关系。多元回归分析用于探索围产期各种特征与Apgar评分之间以及pH与Apgar评分之间的关系。使用逐步逻辑回归分析来评估死亡率的决定因素。 ？1分钟Apgar得分中位数（25％，75％）为6（4,8），与5分钟得分8（7,9）相关，r = .78。在1分钟（6 [4,8]和7 [4,8]）Apgar评分中，男性（n = 557）和女性（n = 508）婴儿之间存在轻微但显着的差异。白人婴儿（7 [4,8]和8 [7,9]; n = 713）的一分钟和五分钟评分显着高于黑人婴儿（5 [3,7]和8 [6,9] ]; n = 280）。出生体重和胎龄均与两个Apgar得分呈线性关系。 Apgar评分低（在1分钟时<3，在5分钟时<6）与出生体重，胎龄和分娩方式显着相关。出生时动脉血pH值低（<7.01）与Apgar得分低有关。 159名婴儿死亡;这些婴儿的体型明显较小（983±382 vs 1462±369 g），未成年（27 vs 31周），动脉血pH较低（7.20±0.18 vs 7.31±0.11），1-（3 [2,6] ] vs 7 [4,8]）和5分钟的Apgar评分（6 [4,8] vs 8 [7,9]），而Apgar评分低的发生率（32％vs 6％）比幸存者要大。结论。在Apgar评分的组成部分中，呼吸强度，肌肉张力和反射活动相互之间具有很好的相关性;心率相关性较差;和最少的颜色。我们的数据证实了Apgar评分在早产儿中的使用有限，并证明了Apgar评分组成部分的不同反应。
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