Abstract:
OBJECTIVE:To investigate associations between Apgar scores of 7, 8, and 9 (versus 10) at 1, 5, and 10 minutes, and neonatal mortality and morbidity. DESIGN:Population based cohort study. SETTING:Sweden. PARTICIPANTS:1 551 436 non-malformed live singleton infants, born at term (≥37 weeks' gestation) between 1999 and 2016, with Apgar scores of ≥7 at 1, 5, and 10 minutes. EXPOSURES:Infants with Apgar scores of 7, 8, and 9 at 1, 5, and 10 minutes were compared with those with an Apgar score of 10 at 1, 5, and 10 minutes, respectively. MAIN OUTCOME MEASURES:Neonatal mortality and morbidity, including neonatal infections, asphyxia related complications, respiratory distress, and neonatal hypoglycaemia. Adjusted odds ratios (aOR), adjusted rate differences (aRD), and 95% confidence intervals were estimated. RESULTS:Compared with infants with an Apgar score of 10, aORs for neonatal mortality, neonatal infections, asphyxia related complications, respiratory distress, and neonatal hypoglycaemia were higher among infants with lower Apgar scores, especially at 5 and 10 minutes. For example, the aORs for respiratory distress for an Apgar score of 9 versus 10 were 2.0 (95% confidence interval 1.9 to 2.1) at 1 minute, 5.2 (5.1 to 5.4) at 5 minutes, and 12.4 (12.0 to 12.9) at 10 minutes. Compared with an Apgar score of 10 at 10 minutes, the aRD for respiratory distress was 9.5% (95% confidence interval 9.2% to 9.9%) for an Apgar score of 9 at 10 minutes, and 41.9% (37.7% to 46.4%) for an Apgar score of 7 at 10 minutes. A reduction in Apgar score from 10 at 5 minutes to 9 at 10 minutes was also associated with higher odds of neonatal morbidity, compared with a stable Apgar score of 10 at 5 and 10 minutes. CONCLUSIONS:In term non-malformed infants with Apgar scores within the normal range (7 to 10), risks of neonatal mortality and morbidity are higher among infants with lower Apgar score values, and also among those experiencing a reduction in score from 5 minutes to 10 minutes (compared with infants with stable Apgar scores of 10).
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Razaz N,Cnattingius S,Joseph KSdoi
10.1136/bmj.l1656subject
Has Abstractpub_date
2019-05-07 00:00:00pages
l1656eissn
0959-8138issn
1756-1833journal_volume
365pub_type
杂志文章abstract::Fetomaternal haemorrhage was studied after 68 consecutive fetal intravascular transfusions performed in 20 patients with Rh isoimmunisation. alpha Fetoprotein concentration was assayed in maternal blood taken before, and immediately after each transfusion and three and 24 hours later. An increase of 50% or more in the...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6660.1379
更新日期:1988-11-26 00:00:00
abstract::There is strong circumstantial evidence that human papillomavirus is a cofactor in the development of cervical neoplasia. Systemic immunosuppression has also been implicated. A study was therefore carried out examining the relation between subtypes of human papillomavirus and local immunocompetent cells in the cervix....
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6649.643
更新日期:1988-09-10 00:00:00
abstract:OBJECTIVES:To report on the country of training and ethnicity of consultants in different specialties in the NHS, on trends in intake to UK medical schools by ethnicity, and on the specialty choices made by UK medical graduates in different ethnic groups. DESIGN:Analysis of official databases of consultants and of stu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38202.364271.BE
更新日期:2004-09-11 00:00:00
abstract::Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard.Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestatio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.j3677
更新日期:2017-08-17 00:00:00
abstract:OBJECTIVE:To document the relative importance of endogenous sex steroids in modulating the frequency of orgasms, the dominant aspect of sexual behaviour in healthy eugonadal men. DESIGN:Measurement of adrenal and testicular sex steroids in a sample of army recruits and study of their relation to frequency of orgasms a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6990.1289
更新日期:1995-05-20 00:00:00
abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6982.768
更新日期:1995-03-25 00:00:00
abstract:OBJECTIVE:To examine the impact of antenatal supplementation with multiple micronutrients or iron and folic acid compared with folic acid alone on birth weight, duration of gestation, and maternal haemoglobin concentration in the third trimester. DESIGN:Cluster randomised double blind controlled trial. SETTING:Two ru...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.a2001
更新日期:2008-11-07 00:00:00
abstract:OBJECTIVE:To determine whether total hip arthroplasty is associated with lower reoperation rates, mortality, and complications, and better function and quality of life than hemiarthroplasty for displaced fractures of the femoral neck in older patients. DESIGN:Systematic review and meta-analysis of randomised trials, q...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.c2332
更新日期:2010-06-11 00:00:00
abstract:OBJECTIVE:To describe the association between epithelial cell IgM, which has previously been associated with an increased incidence of loss of renal graft in children, with a novel cutaneous eruption and unexplained native renal disease. DESIGN:Observational study on children with epithelial cell antibody presenting w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6795.161
更新日期:1991-07-20 00:00:00
abstract::The "four principles plus scope" approach provides a simple, accessible, and culturally neutral approach to thinking about ethical issues in health care. The approach, developed in the United States, is based on four common, basic prima facie moral commitments--respect for autonomy, beneficence, nonmaleficence, and ju...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6948.184
更新日期:1994-07-16 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of early treatment for amblyopia in children. DESIGN:Follow up of outcomes of treatment for amblyopia in a randomised controlled trial comparing intensive orthoptic screening at 8, 12, 18, 25, 31, and 37 months (intensive group) with orthoptic screening at 37 months only (control ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7353.1549
更新日期:2002-06-29 00:00:00
abstract::The opportunities for international public health collaboration through joint business ventures between the USSR and Western nations, an arrangement that would benefit the public, industry, and the medical community, are discussed. Evidence indicates that the state of health of the Soviet population is declining rapi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6777.633
更新日期:1991-03-16 00:00:00
abstract:OBJECTIVE:To investigate pharmaceutical or medical device industry funding of patient groups. DESIGN:Systematic review with meta-analysis. DATA SOURCES:Ovid Medline, Embase, Web of Science, Scopus, and Google Scholar from inception to January 2018; reference lists of eligible studies and experts in the field. ELIGIB...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.l6925
更新日期:2020-01-22 00:00:00
abstract::A study was carried out analysing the operation of a drug rationalisation programme in a central London teaching district that had evolved from experience over 17 years. Creation of a limited list of about 700 drugs had been achieved by local consensus. Drug selection was based on appraisal of efficacy, safety, and co...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6646.465
更新日期:1988-08-13 00:00:00
abstract:OBJECTIVE:To investigate the risk of glioma in adults in relation to mobile phone use. DESIGN:Population based case-control study with collection of personal interview data. SETTING:Five areas of the United Kingdom. PARTICIPANTS:966 people aged 18 to 69 years diagnosed with a glioma from 1 December 2000 to 29 Februa...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38720.687975.55
更新日期:2006-04-15 00:00:00
abstract:OBJECTIVES:To describe the change in first day infant mortality during 1935-87. To examine the hypothesis that excess first day mortality in the 1950s and 1960s was attributable to restricting oxygen for sick newborn infants. DESIGN:Time series analysis of first day infant mortality and stillbirth rates. SETTING:Engl...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6823.343
更新日期:1992-02-08 00:00:00
abstract:OBJECTIVE:To determine whether the more intensive screening and treatment for prostate cancer in the Seattle-Puget Sound area in 1987-90 led to lower mortality from prostate cancer than in Connecticut. DESIGN:Natural experiment comparing two fixed cohorts from 1987 to 1997. SETTING:Seattle-Puget Sound and Connecticut...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.325.7367.740
更新日期:2002-10-05 00:00:00
abstract:OBJECTIVE:To assess the potential effects of primary prevention with anticoagulants or aspirin in atrial fibrillation on Swedish population. DESIGN:Analysis of cost effectiveness based on the following assumptions: about 83,000 people have atrial fibrillation in Sweden, of whom 22,000 would be potential candidates for...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6867.1457
更新日期:1992-12-12 00:00:00
abstract::The development of a molecular genetics diagnostic service over a three year period was studied in a National Health Service region with a population of three million. Starting from a time when few diagnostic applications were possible, the number of disorders and the overall demand had grown rapidly. Conditions for w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6652.843
更新日期:1988-10-01 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6819.93
更新日期:1992-01-11 00:00:00
abstract:OBJECTIVE:To determine the efficacy of high dose folic acid supplementation for prevention of pre-eclampsia in women with at least one risk factor: pre-existing hypertension, prepregnancy diabetes (type 1 or 2), twin pregnancy, pre-eclampsia in a previous pregnancy, or body mass index ≥35. DESIGN:Randomised, phase III...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.k3478
更新日期:2018-09-12 00:00:00
abstract:OBJECTIVES:To measure the impact of socioeconomic deprivation on rates of teenage pregnancy and the extent of local variation in pregnancy rates in Scotland, and to examine how both have changed over time. DESIGN:Population study using routine data from hospital records, aggregated for small areas. SUBJECTS:Female te...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.323.7306.199
更新日期:2001-07-28 00:00:00
abstract:OBJECTIVE:To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence. DESIGN:Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7106.449
更新日期:1997-08-23 00:00:00
abstract:OBJECTIVE:To compare the use and effect of a computer based information system for cancer patients that is personalised using each patient's medical record with a system providing only general information and with information provided in booklets. DESIGN:Randomised trial with three groups. Data collected at start of r...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.319.7219.1241
更新日期:1999-11-06 00:00:00
abstract:OBJECTIVE:To determine the relative contribution of decline in bone density to the increase in risk of hip fracture with age in men and women. DESIGN:Incidence data of hip fracture from the general population were combined with the bone density distribution in a sample from the same population and with a risk estimate...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7102.221
更新日期:1997-07-26 00:00:00
abstract:OBJECTIVE:To examine whether total joint arthroplasty of the hip and knee reduces the risk for serious cardiovascular events in patients with moderate-severe osteoarthritis. DESIGN:Propensity score matched landmark analysis. SETTING:Ontario, Canada. PARTICIPANTS:2200 adults with hip or knee osteoarthritis aged 55 or...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f6187
更新日期:2013-10-30 00:00:00
abstract:OBJECTIVE:To investigate whether residence before and after birth near 50 Hz high voltage installations increases a child's risk of cancer and whether risk correlates with the strength of the magnetic field. DESIGN:A population based case-control study. SETTING:Denmark. SUBJECTS:1707 children under the age of 15 wit...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6909.891
更新日期:1993-10-09 00:00:00
abstract::The rapid aging of populations in developing countries as compared to those in the developed world has implications for medical training in these places. Moreover, the growing globalization of employment for many health professionals means that demographic shifts have implications for the training of health professio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.319.7221.1358
更新日期:1999-11-20 00:00:00
abstract:OBJECTIVES:To investigate the association between four sociodemographic measures (unemployment, overcrowding, low social class, and the proportion of migrants from areas of high prevalence of tuberculosis) and average level and rate of change of notification rates for tuberculosis. DESIGN:Ecological analysis of both t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6985.963
更新日期:1995-04-15 00:00:00
abstract:OBJECTIVES:To audit services for prenatal diagnosis for haemoglobin disorders in the United Kingdom. DESIGN:Comparison of the annual number of cases recorded in a United Kingdom register of prenatal diagnoses for haemoglobin disorders, with the annual number of pregnancies at risk of these disorders, by ethnic group a...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.315.7111.779
更新日期:1997-09-27 00:00:00