Objective. Our general objective of this study is to furtherassess the predictive validity of Apgar scores on infant mortality using a national-level data setallowing for race/ethnic-specific variation. Method. This analysis is based on the 1989–1991NCHS Linked Birth/Infant Death files. Multivariate, multinomial logistic regression modelswere constructed adjusting for maternal behavioral and health risks, socioeconomic and demographicfactors, and infant characteristics. Results. After adjusting for maternal riskfactors, infants with low Apgar scores experienced 86 times the odds of neonatal death relative tohigh Apgar score infants while infants with medium Apgar scores experienced 10 times the odds ofneonatal death relative to the high Apgar referent. After controlling for maternal risk factors,birth weight and gestational age, the effect of low Apgar scores on neonatal mortality risk relativeto high Apgar scores is reduced (from OR = 86.1 to OR = 31.2), but still remains a strong predictor.Fully adjusted, race/ethnic-specific models show that the predictive value oflow Apgar on neonatal mortality risk is strongest for Mexican Americans (OR = 44.2) versusNon-Hispanic Whites and Blacks (OR = 36.2 and 20.4 respectively). Conclusion Ourresults support the conclusion that Apgar scores continue to be strong predictors of infant survival,independent of birth weight, gestational age, and a large number of maternal risk factors.They are also shown to be powerful predictors within different race/ethnic groups, solidifying theirimportance as both a diagnostic tool and descriptive health characteristic across various U.S.populations.
Population Research and Policy Review – Springer Journals
Published: Oct 17, 2004
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