Relationship between the Apgar score and general movements in hospitalized preterm newborns

Abstract

Introduction: In Brazil, the Apgar score is the main indicator of immediate risk at birth and general movements (GMs) are the gold standard markers for neuromotor outcomes. However, there are no studies that have investigate direct differences in GM quality in relation to the Apgar score. Objective: Assess whether the Apgar score is related to GM quality in hospitalized preterm newborns and compare the presence of risk factors in those at high risk against a low-risk control group. Methods: This is an observational study involving the analysis of medical records. Thirty eligible newborns with a gestational age of 34.80 ± 1.41 weeks, hospitalized in the neonatal intermediate care unit, were divided into a high-risk group (1- and 5-minute Apgar score ≤ 7, birth weight < 2,500 grams) and control group (1- and 5- minute Apgar score > 7, birth weight ≥ 2,500 grams). Prechtl’s GM assessment and risk factor analysis were conducted in accordance with the Brazilian National Health System (SUS in Portuguese). Results: There were no intergroup differences for GMs, but differences in biological factors were observed, with the high-risk group exhibiting more problems during pregnancy, labor or birth, and severe jaundice. Conclusion: The Apgar score was not related to GM quality in the preterm newborns studied. However, there were more gestational and perinatal complications and severe jaundice in the high-risk group, indicating a possible relationship between these risk factors.