Developmental Outcomes at 6 Months in Neonates with First-minute Apgar Score Below 7 and Gestational Age More Than 35 Weeks: A Single-center Study

Abstract

Background: The objective of this study was to investigate the relationship between the one-minute Apgar score and developmental outcomes at six months of age. Materials and Methods: This cohort study involved neonates with gestational age of more than 35 weeks and a first-minute Apgar score of less than 7, without major anomalies requiring admission during September 2018-2021. Clinical data and hospital course details were recorded. At 6 months old, participants were contacted, and parental questionnaires regarding age and stages questionnaire (ASQ) were completed. Data were analyzed by SPSS 21, using mean, standard deviation, frequency, and percentage. Dunn test and the Kruskal-Wallis test were also employed. Results: Out of 26,928 neonates born, 865 had an Apgar score of less than 7 and survived the first day, with 208 being more than 35 weeks gestational age and needing admission. Ultimately, 196 neonates were enrolled. The mean gestational age was 38.2± 1.75 and the mean 1st-minute Apgar score was 3.36 ± 1.84. A significant relationship was observed between the 5th-minute Apgar score and cord blood acidosis (P<0.001) and the 10th-minute Apgar score with the need for oxygen (P=0.02(. Most infants had normal ASQ evaluations, while one (0.5%) was in high-risk zone for each domain of fine motor, personal-social, and communication skills. Additionally, one (0.05%) was in the abnormal range for gross motor function, and another one (0.05%) was in the abnormal range for fine motor function. Conclusion: Our study did not identify a relationship between a low first-minute Apgar score and adverse developmental outcomes at 6 months of age.