A study of prognostic significance of apgar score regarding neurodevelopment among neonates with low apgar score in a tertiary care center in southern india

Introduction: Neurodevelopmental outcome of babies born with low Apgar score is a matter of growing concern among Paediatricians and neonatologists. We present here a single institution experience with this simple and financially viable way of testing babies using the Denver Developmental Screening Test to detect early aberrations in the neurodevelopment of neonates.
Material and methods: This was a prospective study to assess the neuro- development, using the Denver Developmental screening test (DDST) on 46 children who were born with a low Apgar score in a tertiary care centre. The children were followed up for three years and assessed in the domains of gross motor, fine motor, social and language milestone.
Results: The Neurodevelopment was normal in 36 (78%) babies with low APGAR (score below 7). Four (8%) babies developed delay in various neuro- developmental parameters. In the remaining six (14%) the results were inconclusive.
Conclusion and clinical significance: There was no statistical significance between the degree of asphyxia and DDST findings in our study. Low Apgar Score, per se, is not indicative of neuro developmental outcome in the new-borns; low Apgar just reflects the severity of birth asphyxia and urgent need for meticulous and aggressive neonatal resuscitation according to Neonatal Resuscitation Protocol (NRP) guidelines. If administered promptly, the neurodevelopmental outcome of babies with low Apgar score is comparable to those born with a normal Apgar score.