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::This paper summarizes the key findings of a U.S. study of 48 primary care physicians acting as gatekeepers in a large health maintenance organization to determine the effects of their cost containment role on the doctor patient relationship. Taylor highlights some of the findings and conclusions that he believes are ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6711.1323
更新日期:1989-11-25 00:00:00
abstract:OBJECTIVE:To compare perinatal outcomes in births of women with versus without a history of bariatric surgery. DESIGN:Population based matched cohort study. SETTING:Swedish national health service. PARTICIPANTS:1,742,702 singleton births identified in the Swedish medical birth register between 1992 and 2009. For eac...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.f6460
更新日期:2013-11-12 00:00:00
abstract:OBJECTIVES:To investigate the feasibility of obtaining signed consent for submission of patient identifiable data to a national clinical audit database and to identify factors influencing the consent process and its success. DESIGN:Feasibility study. SETTING:Seven paediatric intensive care units in England. PARTICIP...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.38404.650208.AE
更新日期:2005-04-16 00:00:00
abstract:OBJECTIVE:To explore the hypothesis that different methods of selecting and printing information for cancer patients could improve emotional support by affecting interaction with others, and so lead to improved psychological wellbeing. DESIGN:Randomised trial with eight groups (three factors, 2x2x2). Data collected at...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.38807.571042.68
更新日期:2006-04-22 00:00:00
abstract:OBJECTIVES:To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN:A consecutive case study of remand prisoners screened at reception for substanc...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7099.18
更新日期:1997-07-05 00:00:00
abstract:OBJECTIVES:To determine whether informed consent introduces selection bias in prospective observational studies using data from medical records, and consent rates for such studies. DESIGN:Systematic review. DATA SOURCES:Embase, Medline, and the Cochrane Library up to March 2008, reference lists from pertinent article...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.b866
更新日期:2009-03-12 00:00:00
abstract:OBJECTIVE:To investigate the independent effects of intake of fruit and vegetables on incidence of type 2 diabetes. DESIGN:Systematic review and meta-analysis. DATA SOURCES:Medline, Embase, CINAHL, British Nursing Index (BNI), and the Cochrane library were searched for medical subject headings and keywords on diabete...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.c4229
更新日期:2010-08-18 00:00:00
abstract:OBJECTIVES:To report the sensitivities of the faecal occult blood test, screening episode, and screening programme for colorectal cancer and the benefits of applying a randomised design at the implementation phase of a new public health policy. DESIGN:Experimental design incorporated in public health evaluation using ...
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.a2261
更新日期:2008-11-20 00:00:00
abstract:OBJECTIVE:To assess whether a raised serum troponin T concentration would be an independent predictor of death in patients with an acute ischaemic stroke. DESIGN:Observational study. SETTING:Auckland Hospital, Auckland, New Zealand. SUBJECTS:All 181 patients with an acute ischaemic stroke admitted over nine months i...
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更新日期:2000-06-03 00:00:00
abstract:OBJECTIVE:To investigate the association between treatment induced change in high density lipoprotein cholesterol and total death, coronary heart disease death, and coronary heart disease events (coronary heart disease death and non-fatal myocardial infarction) adjusted for changes in low density lipoprotein cholestero...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
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更新日期:2009-02-16 00:00:00
abstract:OBJECTIVE:To assess evidence from randomised clinical trials about the effectiveness of extracts of Boswellia serrata (frankincense). DESIGN:Systematic review. DATA SOURCES:Electronic searches on Medline, Embase, Cinahl, Amed, and Cochrane Library. Hand searches of conference proceedings, bibliographies, and departme...
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pub_type: 杂志文章,评审
doi:10.1136/bmj.a2813
更新日期:2008-12-17 00:00:00
abstract:OBJECTIVE:To assess body shape trajectories in early and middle life in relation to risk of mortality. DESIGN:Prospective cohort study. SETTING:Nurses' Health Study and Health Professionals Follow-up Study. POPULATION:80 266 women and 36 622 men who recalled their body shape at ages 5, 10, 20, 30, and 40 years and p...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.i2195
更新日期:2016-05-04 00:00:00
abstract:OBJECTIVE:To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). DESIGN:Follow up study of 3 months. SETTING:Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.319.7214.878
更新日期:1999-10-02 00:00:00
abstract:OBJECTIVE:To establish the extent of prescribing injectable and oral methadone to opiate addicts and the practice characteristics and dispensing arrangements attached to these prescriptions. DESIGN:National survey of 25% random sample of community (high street) pharmacies through postal questionnaire, with four mailin...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7052.270
更新日期:1996-08-03 00:00:00
abstract:OBJECTIVES:To compare the efficacy and tolerability of butterbur (Petasites hybridus) with cetirizine in patients with seasonal allergic rhinitis (hay fever). DESIGN:Randomised, double blind, parallel group comparison. SETTING:Four outpatient general medicine and allergy clinics in Switzerland and Germany. PARTICIPA...
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pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7330.144
更新日期:2002-01-19 00:00:00
abstract:OBJECTIVE:To determine how length of anticoagulation and clinical presentation of venous thromboembolism influence the risk of recurrence after anticoagulant treatment is stopped and to identify the shortest length of anticoagulation that reduces the risk of recurrence to its lowest level. DESIGN:Pooled analysis of in...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.d3036
更新日期:2011-05-24 00:00:00
abstract:OBJECTIVE:To determine the risk factors for neonatal encephalopathy among term infants in a developing country. DESIGN:Unmatched case-control study. SETTING:Principal maternity hospital of Kathmandu, Nepal. SUBJECTS:All 131 infants with neonatal encephalopathy from a population of 21 609 infants born over an 18 mont...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.320.7244.1229
更新日期:2000-05-06 00:00:00
abstract:OBJECTIVE:To evaluate the impact of the US Air Force suicide prevention programme on risk of suicide and other outcomes that share underlying risk factors. DESIGN:Cohort study with quasi-experimental design and analysis of cohorts before (1990-6) and after (1997-2002) the intervention. PARTICIPANTS:5,260,292 US Air F...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.327.7428.1376
更新日期:2003-12-13 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1995-04-15 00:00:00
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doi:10.1136/bmj.313.7065.1119
更新日期:1996-11-02 00:00:00
abstract:OBJECTIVE:To determine whether the intervention of a physiotherapist improved mobility in patients seen more than one year after stroke. DESIGN:Randomised crossover trial comparing two groups offered intervention by a physiotherapist, one immediately after entry into the trial and the other after a delay of three mont...
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1992-03-07 00:00:00
abstract:OBJECTIVE:To examine the effect of the method of data display on physician investigators' decisions to stop hypothetical clinical trials for an unplanned statistical analysis. DESIGN:Prospective, mixed model design with variables between subjects and within subjects (repeated measures). SETTING:Comprehensive cancer c...
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pub_type: 杂志文章
doi:10.1136/bmj.318.7197.1527
更新日期:1999-06-05 00:00:00
abstract::Elderly and disabled people have been led to expect great improvements in the quality of community care after April 1993. The choice to live safely at home is to be offered as an alternative to residential care. The financial and organisational relationships are all intended to support this in practice. The Tomlinson ...
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pub_type: 杂志文章
doi:10.1136/bmj.305.6866.1418
更新日期:1992-12-05 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6863.1184
更新日期:1992-11-14 00:00:00
abstract:OBJECTIVE:To investigate the effect of two different food supplements on body mass index (BMI) in wasted Malawian adults with HIV who were starting antiretroviral therapy. DESIGN:Randomised, investigator blinded, controlled trial. SETTING:Large, public clinic associated with a referral hospital in Blantyre, Malawi. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.b1867
更新日期:2009-05-22 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6955.648
更新日期:1994-09-10 00:00:00
abstract:OBJECTIVE:To examine period trends in the rate of suicide in the first 28 days after discharge from psychiatric hospital. DESIGN:Cohort study of patients discharged from psychiatric hospital. SETTING:Scotland. SUBJECTS:All patients aged 15-84 who were discharged from Scottish psychiatric hospitals during 1968 to 199...
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pub_type: 杂志文章
doi:10.1136/bmj.311.7001.357
更新日期:1995-08-05 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6814.1357
更新日期:1991-11-30 00:00:00