{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:45:22Z","timestamp":1789170322688,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T00:00:00Z","timestamp":1518393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004212","name":"P\u00e4ivikki ja Sakari Sohlbergin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004212","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study evaluated the associations between low Apgar scores at one and five minutes and long\u2010term neurological impairments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used population\u2010based data on 399,815 singletons born in Finland in 2004\u20102010 and multivariable logistic regression to examine any associations between low (0\u20133) and intermediate (4\u20136) Apgar scores and cerebral palsy, epilepsy, intellectual disability and sensorineural defects by the age of four years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The odd ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) and 95% confidence intervals (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) showed that low Apgar scores were associated with cerebral palsy at one and five minutes (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s 2.08, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.32\u20133.26 and 5.19, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.06\u20138.80), epilepsy (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s 1.62, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.13\u20132.33 and 4.79, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.03\u20137.56), and intellectual disability (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s 2.46, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.45\u20134.16 and 6.21, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.33\u201311.58). Only a low five\u2010minute Apgar score was associated with sensorineural defects (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.13, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.95\u20135.02). Neurological impairment risks were increased by low Apgar scores at both one and five minutes (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 11.1, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 8.6\u201314.5), but 90.3% of children with persistent low Apgar scores had no impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low one\u2010minute and five\u2010minute Apgar scores were associated with long\u2010term neurological morbidity, especially when both scores were low.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.14234","type":"journal-article","created":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T07:26:42Z","timestamp":1516692402000},"page":"942-951","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Low Apgar scores at both one and five minutes are associated with long\u2010term neurological morbidity"],"prefix":"10.1111","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6465-2169","authenticated-orcid":false,"given":"Elina","family":"Leinonen","sequence":"first","affiliation":[{"name":"Children\u2032s Hospital University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Information Services Department National Institute for Health and Welfare Helsinki Finland"},{"name":"Division of Family Medicine Department of Neurobiology, Care Sciences and Society Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Haataja","sequence":"additional","affiliation":[{"name":"Children\u2032s Hospital University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petri","family":"Rahkonen","sequence":"additional","affiliation":[{"name":"Children\u2032s Hospital University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sture","family":"Andersson","sequence":"additional","affiliation":[{"name":"Children\u2032s Hospital University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjo","family":"Mets\u00e4ranta","sequence":"additional","affiliation":[{"name":"Children\u2032s Hospital University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Rahkonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-195301000-00041"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200102153440701"},{"key":"e_1_2_9_4_1","first-page":"222","article-title":"The Apgar score as an index of neonatal mortality. 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