Low Apgar Scores Associated With Cerebral Palsy

Association stronger in children of normal weight at birth
By Monica Smith
HealthDay Reporter

FRIDAY, Oct. 8 (HealthDay News) -- Low Apgar scores at birth appear to be strongly associated with the development of cerebral palsy, more so in children of normal birth weight than those of low birth weight, according to research published Oct. 7 in BMJ.

Kari Kveim Lie, M.D., of the Norwegian Institute of Public Health in Oslo, and colleagues identified the number of children with cerebral palsy out of 543,064 singleton births in Norway. They then assessed the association between Apgar scores and cerebral palsy in children of both normal and low birth weight and with subdiagnoses of cerebral palsy: quadriplegia, diplegia, and hemiplegia.

The researchers found that 39 (11 percent) of the 369 children with an Apgar score of less than three were diagnosed with cerebral palsy, compared with 0.1 percent of those with an Apgar score of 10. In children who weighed 2,500 grams or more at birth, those with an Apgar score below four had a much higher risk of cerebral palsy than those whose Apgar score was above eight (odds ratio, 125). In children who weighed below 1,500 grams, the corresponding odds ratio was 5. Low Apgar score was also strongly associated with cerebral palsy's three subtypes, especially quadriplegia.

"Low Apgar score was strongly associated with cerebral palsy. This association was high in children with normal birth weight and modest in children with low birth weight. The strength of the association differed between subgroups of spastic cerebral palsy. Given that Apgar score is a measure of vitality shortly after birth, our findings suggest that the causes of cerebral palsy are closely linked to factors that reduce infant vitality," the authors write.

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