The Apgar score: is it enough?

One thousand thirty-two neonates were evaluated with umbilical venous and arterial blood samples drawn at delivery for assessment of pH, PO2, PCO2, and base deficit. These values were statistically correlated with Apgar scores in all of the neonates studied. Infants were divided into Apgar groupings (group A, greater than or equal to 7 at one and five minutes; group B, less than 7 at one minute, greater than or equal to 7 at five minutes; group C, less than or equal to 7 at both one and five minutes). Generally, umbilical artery and umbilical venous data were parallel. The differences in means for pH, PO2, PCO2, and base deficit was significant when group A was compared with group B in both umbilical artery and umbilical venous data. However, a severe degree of biochemical disturbance must take place before significant association with neonatal depression can be made. It appears that umbilical blood biochemical data are related to fetal metabolic status before birth but only modestly influence the one-minute Apgar score.