Apgar Score Plus Umbilical Artery pH and Adverse Neonatal Outcomes in Very Preterm Infants

Is the addition of umbilical artery pH (UA-pH) to the 5-minute Apgar score associated with more accurate risk estimates for adverse neonatal outcome?In this cohort study of 4174 liveborn VPT infants, those with Apgar score lower than 7 had similar risks of a composite mortality and morbidity outcome regardless of low or normal UA-pH. Mortality risk was highest for infants with an Apgar score lower than 7 and a low UA-pH, severe intraventricular hemorrhage risk was elevated when either Apgar score or UA-pH was low, and only Apgar score lower than 7 and a normal UA-pH was associated with bronchopulmonary dysplasia risk.The findings of this study suggest that combining information on UA-pH with Apgar score is associated with improved estimation of risk for individual components of composite neonatal outcomes.

Corresponding Author: Harald Ehrhardt, MD, Department of Neonatology, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany (harald.ehrhardt@charite.de).

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