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Association between low Apgar score and neonatal cholestasis
B Fischler1, M Pettersson, A Hjern
1Department of Paediatrics, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden. bjorn.fischler@hs.se
Acta Paediatrica (Oslo, Norway : 1992)
|May 6, 2004
Summary
Low Apgar scores are not more common in infants with cholestasis than in the general newborn population. Further investigation into other causes is needed for cholestasis of unknown origin.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Perinatal Health
Background:
- Cholestasis in infants is a serious condition requiring prompt diagnosis.
- The Apgar score is a key indicator of newborn health at birth.
Purpose of the Study:
- To determine if a low Apgar score is associated with the development of infant cholestasis.
- To explore potential links between Apgar scores and specific causes of cholestasis.
Main Methods:
- Retrospective study of 77 cholestatic infants and over 1 million controls.
- Data sourced from the Swedish Medical Birth Registry, including Apgar scores, gestational age, and birthweight.
- Medical records reviewed for neonatal distress in infants with low Apgar scores.
Main Results:
- Only five cholestatic infants met the criteria for a low Apgar score, primarily premature infants.
- Two cases were explained by major surgical issues; three had signs of neonatal distress (two with biliary atresia, one with Alagille syndrome).
- Incidence of low Apgar scores in biliary atresia (7%) and unknown cholestasis (0%) did not significantly differ from controls (2.6%).
Conclusions:
- A low Apgar score is not a more frequent finding in cholestatic infants compared to the general newborn population.
- Etiological factors beyond a low Apgar score should be investigated for infants presenting with unexplained cholestasis.