The association of Apgar score with subsequent death and cerebral palsy: A population-based study in term infants

J Pediatr. 2001 Jun;138(6):798-803. doi: 10.1067/mpd.2001.114694.


Objective: To estimate the risk of adverse outcomes for newborns with a low Apgar score.

Study design: Population-based cohort study. All 235,165 children born between 1983 and 1987 in Norway with a birth weight of at least 2500 g and no registered birth defects were followed up from birth to age 8 to 12 years by linkage of 3 national registries. Outcomes were death and cerebral palsy (CP).

Results: Five-minute Apgar scores of 0 to 3 were recorded for 0.1%, and scores of 4 to 6 were recorded for 0.6% of the children. Compared with children who had 5-minute Apgar scores of 7 to 10, children who had scores of 0 to 3 had a 386-fold increased risk for neonatal death (95% CI: 270-552) and an 81-fold (48-138) increased risk for CP. If Apgar scores at both 1 and 5 minutes were 0 to 3, the risks for neonatal death and CP were increased 642-fold (442-934) and 145-fold (85-248), respectively, compared with scores of 7 to 10.

Conclusion: The strong association of low Apgar scores with death and CP in this population with a low occurrence of low scores shows that the Apgar score remains important for the early identification of infants at increased risk for serious and fatal conditions.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Apgar Score*
  • Cerebral Palsy / diagnosis*
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Newborn, Diseases / mortality*
  • Predictive Value of Tests
  • Risk