Valentin L, Ekman G, Isberg P E, Polberger S, Marsál K
Lund University, Department of Obstetrics and Gynaecology, Malmö, Sweden.
Arch Gynecol Obstet. 1993;253(2):103-15. doi: 10.1007/BF02768736.
The relation between intra-partum cardiotocography (CTG), cord blood acid-base status, Apgar score and neonatal morbidity was studied in 1228 consecutively live-born babies and in a subgroup of 200 babies (148 babies with a 1 min Apgar score < or = 8 and 52 randomly selected babies with a 1 min Apgar score > or = 9). The scores for the individual components of the 1 min Apgar score were strongly associated with each other, whereas the scores for the individual components of the 5 min Apgar score were less strongly associated. At 1 min the scores for muscle tone, reflex irritability and respiration but not the scores for heart rate and skin colour were associated with arterial and venous cord blood pH (low scores being associated with low pH). Out of the individual components of the Apgar score, heart rate and reflex irritability at 1 min were the best discriminators between "healthy or relatively healthy" and "severely ill" babies. Intrapartum CTG, total Apgar score and cord blood acid-base status were only weakly related. Venous cord blood pH was the best predictor of the 1 min Apgar score. Intra-partum CTG (silent pattern), 5 min Apgar score and venous cord blood pH were the best predictors of severe neonatal morbidity.
对1228例连续活产婴儿以及200例婴儿亚组（148例1分钟阿氏评分≤8分的婴儿和52例随机选取的1分钟阿氏评分≥9分的婴儿）研究了产时胎心监护（CTG）、脐血酸碱状态、阿氏评分与新生儿发病率之间的关系。1分钟阿氏评分各单项得分之间密切相关，而5分钟阿氏评分各单项得分之间的相关性较弱。1分钟时，肌张力、反射应激性和呼吸的评分与脐动脉血和脐静脉血pH值相关，而心率和皮肤颜色评分与之无关（低分与低pH值相关）。在阿氏评分各单项中，1分钟时的心率和反射应激性是“健康或相对健康”与“重症”婴儿之间的最佳鉴别指标。产时CTG、阿氏总分和脐血酸碱状态之间仅有微弱关联。脐静脉血pH值是1分钟阿氏评分的最佳预测指标。产时CTG（寂静型）、5分钟阿氏评分和脐静脉血pH值是严重新生儿发病率的最佳预测指标。
