Within the first few moments babies are pulled from the womb doctors administer the first test of their young lives. Known as an Apgar score, doctors use the scale to evaluate each infants physical condition — and determine if there are any deficiencies that require additional medical addention— or that need to be monitored.
Doctors usually will perform an Apgar test on the baby within the first few minutes of birth, with a follow-up to test to be given shortly thereafter or as necessary.
Five, different factors are evaluated when calculating a babies Apgar score:
- Heart rate (pulse)
- Breathing (rate)
- Grimace (responsiveness to stimuli)
- Activity (muscle tone)
- Appearance (colorization in skin)
Each factor is given a score of 0, 1 or 2, then the scores are added together to calculate a baby’s Apgar score on a scale of 0 to 10.
In the past, Apgar scores weren’t given particular weight when it came to determining a babies long-term health as child developmental needs vary considerably.
Now, new research tends to question this long-held assumption as there does indeed appear to be a correlation between low Apgar scores and a later diagnosis of Cerebral Palsy.
In evaluating more than 500,000 children born in Norway, the study analyzed the Apgar scores in children who were diagnosed with Cerebral Palsy. The results revealed that children with Apgar score below three were more than 100 times more likely to be diagnosed with Cerebral Palsy than their higher scoring peers.
Certainly, more research needs to be conducted in this important field of infant vitality, but the now that the connection between Apgar scores and Cerebral Palsy has been strengthened, the next step would be to evaluate if there is an explanation for the low Apgar score at the time of delivery.
Though genetic factors and pre-mature births can impact Apgar scores, other explanations may related to physician error during delivery. The following conditions are related to to Apgar scores in children as suggested by brighthub.com:
• Precipitous delivery. Hypoxia (oxygen deficiency) can occur from a fast birth due to strong contractions or trauma to the baby’s head.
• Nuchal cord. If the cord is wrapped around the fetal neck (one or more times) and obstructs blood flow, hypoxia can occur.
• Prolapsed cord. When the cord becomes trapped in the vagina before the fetus is delivered, hypoxia can occur from obstructed blood flow.
• Placenta previa or abruptio placentae. Both can cause low infant Apgar scores because the placenta separates from the uterus before delivery, interrupting blood flow.
• Meconium aspiration. The fetus can have a bowel movement (meconium) in utero when distressed and may inhale some into their lungs, thus causing respiratory problems.
• Maternal analgesics and/or anesthetics. Narcotic drugs (normally given within 4 hours before birth) that pass from mom to fetus can suppress their ability to breathe.
• Preterm infants. Immature lungs and hypoglycemia are a couple of problems that can occur with preterm infants.
• Other common causes of low Apgar scores include maternal and fetal factors, such as maternal hemorrhage or fetal heart problem.
If you suspect that your child’s low Apgar score was a predecessor to a later discovered brain injury or Cerebral Palsy, we would honor the opportunity to discuss your potential legal rights with you today without any cost or obligation for you. (888) 424-5757
Resources:
Association of cerebral palsy with Apgar score in low and normal birthweight infants- population based cohort study (PDF) by Kari Kveim Lie, senior researcher,1 Else-Karin Grøholt, senior researcher,1 Anne Eskild, professor2,3
Apgar Score MedicineNet.com
Regional Brain Volume Abnormalities and Long-term Cognitive Outcome in Preterm Infants (PDF) JAMA, October 18, 2000—Vol 284, No. 15
Should parents be concerned if their child has been diagnosed with meconium aspiration syndrome?