Predictive value of Apgar scores for developmental outcome in premature infants

For more than two decades, Apgar scores have been used to predict developmental outcome in newborns. However, most studies have used full-term babies for their data base, and the predictive value of Apgar scores for low birthweight infants has remained unclear. This study was designed to provide a data base for premature infants, demonstrating to what degree Apgar scores predict developmental outcome. We tested Apgar scores alone and in combination with two other easily quantified variables, birthweight and gestational age, as predictors of risk for 256 infants weighing less than 1800 gm at birth. Although significant correlations existed between Apgar scores and Bayley Mental and Psychomotor Developmental Indices, multiple regression analyses demonstrated that these relationships were not significant independent of birthweight and gestational age. That is, after controlling for birthweight and gestational age, Apgar scores did not predict morbidity in low birthweight infants and should not be used to provide a developmental prognosis.