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The 5-minute Apgar Score as a Prognostic Factor for Development and Progression of Retinopathy of Prematurity
Vasil G Marinov1, Desislava N Koleva-Georgieva1, Nelly P Sivkova1
1Department of Ophthalmology, Faculty of Medicine, Medical University of Plovdiv, 15A Vassil Aprilov Blvd., 4002 Plovdiv.
Insights
A low 5-minute Apgar score does not predict retinopathy of prematurity (ROP) development. However, an Apgar score of 6 or less indicates a higher risk of ROP progression requiring treatment.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Perinatal Research
Background:
- A low 5-minute Apgar score is a known risk factor for retinopathy of prematurity (ROP).
- Understanding prognostic indicators for ROP is crucial for timely intervention.
Purpose of the Study:
- To evaluate the predictive value of the 5-minute Apgar score for ROP development and progression.
- To identify independent risk factors associated with ROP manifestation and advancement.
Main Methods:
- Retrospective analysis of 118 preterm infants screened for ROP.
- Apgar scores at 5 minutes were analyzed as absolute values and ≤ 6.
- Statistical analysis included Mann-Whitney U, chi-squared, Fisher's exact tests, and logistic regression.
Main Results:
- A low 5-minute Apgar score (or ≤ 6) was not a significant predictor of ROP development (p=0.191).
- However, an Apgar score of ≤ 6 at 5 minutes was a significant risk factor for ROP progression to treatment stages (p=0.046).
Conclusions:
- A 5-minute Apgar score of 6 or less is a significant, independent risk factor for ROP progression.
- This finding aids in identifying high-risk infants requiring closer monitoring for ROP advancement.
Background:
A low Apgar score at 5 minutes has been shown to be a risk factor for development of retinopathy of prematurity (ROP).
Aim:
To examine the prognostic value of Apgar score at 5 minutes for development and progression of ROP.
Materials And Methods:
The study included 132 preterm infants who were screened from 4th week of life onward. Of these, 118 newborns were given Apgar score at 5 minutes. The prognostic significance of this index was studied as an absolute value and as a value ≤ 6. The patients were divided into two groups: group I had no evidence of ROP (n=82) and group II had some signs of ROP (n = 36). Group II was further divided into group IIA - spontaneously regressed cases (n=22), and group IIB with cases which progressed to treatment stages (n=14). We investigated 15 maternal and 20 newborn presumable risk factors for development and progression of ROP. Mann-Whitney U test, χ2 or Fisher's exact test were used in the statistical analysis. Logistic regression was performed to find significant and independent risk factors for manifestation and progression of ROP.
Results:
A low 5-minute Apgar score and an Apgar score of 6 or less at 5 minutes were not statistically significant risk factors of ROP (р=0.191, р=0.191, respectively), but were significant risk factors for the manifested ROP to progress to stages requiring treatment (p=0.046, р=0.036, respectively).
Conclusion:
An Apgar score at 5 minutes of 6 or less was a significant and independent risk factor for progression of ROP to stages requiring treatment.
