Abstract
Objective
To test the non-inferiority of an alternative to the Apgar score.
Study design
The Neonatal Resuscitation and Adaptation Score (NRAS) was recorded in parallel to the Apgar score by a resuscitation team at deliveries. Correlation between the systems was assessed, as well as the predictive ability of NRAS and Apgar scores for mortality or short-term morbidities.
Results
A total of 340 infants were in the study group. The two scores correlated strongly (r = 0.87 and 0.83 at 1 and 5 min, respectively). Those needing ventilation at 48 h of life had a 5-min NRAS < 7 in 23/26 vs Apgar < 7 (23/36, p = 0.001). A low (0–3) 1-min NRAS score was more predictive of death, 53% vs 17%, p = 0.0065.
Conclusions
NRAS correlates with Apgar status assessment, and identifies newborns who die or may require further care better than the Apgar score.
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Change history
19 September 2018
Since the publication of the above article, the authors have noted that the name of the first Item in the NRAS scoring system in Figure 1 was omitted. It is Heart Rate (C1). The authors apologise for any inconvenience caused by this error. The html and online pdf versions have now been rectified and carry the corrected Figure.
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Witcher, T.J., Jurdi, S., Kumar, V. et al. Neonatal Resuscitation and Adaptation Score vs Apgar: newborn assessment and predictive ability. J Perinatol 38, 1476–1482 (2018). https://doi.org/10.1038/s41372-018-0189-5
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DOI: https://doi.org/10.1038/s41372-018-0189-5
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