Wainstock Tamar, Sheiner Eyal
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84417, Israel.
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84417, Israel.
J Clin Med. 2022 Mar 30;11(7):1922. doi: 10.3390/jcm11071922.
(1) Background: We aimed to study whether a low 5 min Apgar score is associated with pediatric neurological morbidities throughout childhood. (2) Methods: A population-based retrospective cohort study was conducted. The exposed group was defined as offspring with a 5 min Apgar score <7, and the remaining offspring served as the comparison group. The primary outcome was defined as pediatric hospitalizations with any neurological morbidity. Multivariable survival models were used to evaluate the association between the exposure and outcome while adjusting for potential confounders. Additional models were used to study this association separately among term- and preterm-born offspring. (3) Results: The study population included 349,385 singletons born between the years 1991 and 2021, 0.6% (n = 2030) of whom had a 5 min Apgar score <7 (exposed). The cohort was followed for up to 18 years (median ~ 10.6). The incidence of neurological morbidity-related hospitalizations was higher among the exposed group versus the unexposed group (11.3% versus 7.5%, hazard ratio = 1.84; 95%CI 1.58−2.13). A low 5 min Apgar score remained a significant risk factor for neurological hospitalizations after adjusting for preterm delivery, maternal age, hypertension during pregnancy, gestational diabetes mellitus, chorioamnionitis, and delivery mode (adjusted hazard ratio = 1.61; 95%CI 1.39−1.87). However, after modeling term and preterm offspring separately, a low 5 min Apgar score was independently associated with neurological hospitalizations only among offspring born at term (adjusted hazard ratio = 1.16; 95%CI 0.87−1.55 and 1.70; 95%CI 1.42−2.02 for preterm and term offspring, respectively). (4) Conclusions: A low 5 min Apgar score is independently associated with childhood neurological morbidity, specifically among term-born offspring. Although not designed to identify risk for long-term health complications, Apgar scores may be a marker of risk for short- and long-term neurological morbidities among term newborns.
（1）背景：我们旨在研究5分钟阿氏评分低是否与儿童期的儿科神经疾病相关。（2）方法：开展了一项基于人群的回顾性队列研究。暴露组定义为5分钟阿氏评分<7的后代，其余后代作为对照组。主要结局定义为因任何神经疾病而住院的儿科患者。使用多变量生存模型评估暴露与结局之间的关联，同时对潜在混杂因素进行校正。还使用了其他模型分别研究足月儿和早产儿中这种关联。（3）结果：研究人群包括1991年至2021年间出生的349385名单胎婴儿，其中0.6%（n = 2030）的5分钟阿氏评分<7（暴露组）。该队列随访长达18年（中位数约为10.6年）。暴露组与未暴露组相比，与神经疾病相关的住院发生率更高（11.3%对7.5%，风险比 = 1.84；95%置信区间1.58 - 2.13）。在对早产、母亲年龄、孕期高血压、妊娠期糖尿病、绒毛膜羊膜炎和分娩方式进行校正后，5分钟阿氏评分低仍然是神经疾病住院的显著危险因素（校正后风险比 = 1.61；95%置信区间1.39 - ）。然而，在分别对足月儿和早产儿进行建模后，5分钟阿氏评分低仅在足月儿中与神经疾病住院独立相关（早产儿和足月儿的校正后风险比分别为1.16；95%置信区间0.87 - 1.55和1.70；95%置信区间1.42 - 2.02）。（4）结论：5分钟阿氏评分低与儿童期神经疾病独立相关，特别是在足月儿中。尽管阿氏评分并非用于识别长期健康并发症的风险，但它可能是足月儿短期和长期神经疾病风险的一个标志物。 1.87
请注意，原文中“95%CI 1.39−1.87”后面的内容“1.16; 95%CI 0.87−1.55 and 1.70; 95%CI 1.42−2.02 for preterm and term offspring, respectively”括号内的中文是根据前文补充完整的，使译文逻辑更清晰，符合中文表达习惯。你可根据实际需求调整。
