Neonates with a 10-min Apgar score of zero: Outcomes by gestational age

You Jia Zhong; Martine Claveau; Eugene W. Yoon; Khalid Aziz; Nalini Singhal; Prakesh S. Shah; Pia Wintermark; Jaideep Kanungo; Joseph Ting; Zenon Cieslak; Rebecca Sherlock; Wendy Yee; Jennifer Toye; Carlos Fajardo; Zarin Kalapesi; Koravangattu Sankaran; Sibasis Daspal; Mary Seshia; Ruben Alvaro; Amit Mukerji; Orlando Da Silva; Chuks Nwaesei; Kyong Soon Lee; Michael Dunn; Brigitte Lemyre; Kimberly Dow; Ermelinda Pelausa; Keith Barrington; Christine Drolet; Bruno Piedboeuf; Marc Beltempo; Valerie Bertelle; Roderick Canning; Hala Makary; Cecil Ojah; Luis Monterrosa; Julie Emberley; Jehier Afifi; Andrzej Kajetanowicz; Shoo K. Lee

doi:10.1016/j.resuscitation.2019.07.036

Neonates with a 10-min Apgar score of zero: Outcomes by gestational age

You Jia Zhong, Martine Claveau, Eugene W. Yoon, Khalid Aziz, Nalini Singhal, Prakesh S. Shah, Pia Wintermark, Jaideep Kanungo, Joseph Ting, Zenon Cieslak, Rebecca Sherlock, Wendy Yee, Jennifer Toye, Carlos Fajardo, Zarin Kalapesi, Koravangattu Sankaran, Sibasis Daspal, Mary Seshia, Ruben Alvaro, Amit MukerjiOrlando Da Silva, Chuks Nwaesei, Kyong Soon Lee, Michael Dunn, Brigitte Lemyre, Kimberly Dow, Ermelinda Pelausa, Keith Barrington, Christine Drolet, Bruno Piedboeuf, Marc Beltempo, Valerie Bertelle, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Julie Emberley, Jehier Afifi, Andrzej Kajetanowicz, Shoo K. Lee

Medicine

Résultat de recherche: Article › examen par les pairs

15 Citations (Scopus)

Résumé

Background: The current resuscitation guidelines for neonates recommend considering stopping resuscitation efforts if the heart rate remains undetectable after 10 min of adequate resuscitation. However, this recommendation does not take into account the gestational age (GA) of the neonates. We determined the outcomes of neonates with a 10-min Apgar score of zero (Apgar¹⁰ = 0) with respect to their GA. Methods: In a retrospective matched cohort study, we studied neonates admitted to the Canadian Neonatal Network NICUs between 2010 and 2016 with an Apgar¹⁰ = 0. The neonates were divided into 3 subgroups according to their GA: (1) ≥36 weeks’, (2) 32^0/7–35^6/7 weeks’, and (3) <32 weeks’. Each neonate with Apgar¹⁰ = 0 was matched 1:1 with neonates of same GA and sex but Apgar¹⁰ = 1–2 and Apgar¹⁰ = 3–5. Survival and brain injury were compared between matched groups. Results: 177 neonates had Apgar¹⁰ = 0. Survival to discharge was significantly different between GA groups [≥36 weeks’ 61% vs. 32^0/7–35^6/7 weeks’ 58% vs. <32 weeks’ 35%, p = 0.04]. Survival to discharge was similar to their matched cohort with Apgar¹⁰ = 1–2 for neonates born at ≥36 weeks’ (61% vs. 66%) and between 32^0/7 to 35^6/7 weeks’ (58% vs. 54%), but significantly different for neonates <32 weeks (35% vs. 61%, p = 0.04). Conclusion: Neonates with Apgar¹⁰ = 0 had different outcomes depending on their GA. Less than half of neonates born at <32 weeks GA survived; however, a majority of neonates born at 32^0/7–35^6/7 weeks’ and ≥36 weeks’ GA survived at similar rates than their matched neonates with Apgar¹⁰ = 1–2.

Langue d'origine	English
Pages (de-à)	77-84
Nombre de pages	8
Journal	Resuscitation
Volume	143
DOI	https://doi.org/10.1016/j.resuscitation.2019.07.036
Statut de publication	Published - oct. 2019

Note bibliographique

Funding Information:
Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant ( CTP 87518 ), the Ontario Ministry of Health and in-kind support from Mount Sinai Hospital . Dr. Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Dr. Wintermark holds a FRSQ Clinical Research Scholar Career Awards Junior 2. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Funding Information:
The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON for organizational support of CNN. In addition, we thank Sarah Hutchinson, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and in-kind support from Mount Sinai Hospital.

Funding Information:
Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (CTP 87518), the Ontario Ministry of Health and in-kind support from Mount Sinai Hospital. Dr. Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Dr. Wintermark holds a FRSQ Clinical Research Scholar Career Awards Junior 2. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON for organizational support of CNN. In addition, we thank Sarah Hutchinson, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and in-kind support from Mount Sinai Hospital.

Publisher Copyright:
© 2019 Elsevier B.V.

ASJC Scopus Subject Areas

Emergency Medicine
Emergency
Cardiology and Cardiovascular Medicine

PubMed: MeSH publication types

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Accès au document

10.1016/j.resuscitation.2019.07.036

Autres fichiers et liens

Citer

Zhong, Y. J., Claveau, M., Yoon, E. W., Aziz, K., Singhal, N., Shah, P. S., Wintermark, P., Kanungo, J., Ting, J., Cieslak, Z., Sherlock, R., Yee, W., Toye, J., Fajardo, C., Kalapesi, Z., Sankaran, K., Daspal, S., Seshia, M., Alvaro, R., ... Lee, S. K. (2019). Neonates with a 10-min Apgar score of zero: Outcomes by gestational age. Resuscitation, 143, 77-84. https://doi.org/10.1016/j.resuscitation.2019.07.036

Zhong, YJ, Claveau, M, Yoon, EW, Aziz, K, Singhal, N, Shah, PS, Wintermark, P, Kanungo, J, Ting, J, Cieslak, Z, Sherlock, R, Yee, W, Toye, J, Fajardo, C, Kalapesi, Z, Sankaran, K, Daspal, S, Seshia, M, Alvaro, R, Mukerji, A, Da Silva, O, Nwaesei, C, Lee, KS, Dunn, M, Lemyre, B, Dow, K, Pelausa, E, Barrington, K, Drolet, C, Piedboeuf, B, Beltempo, M, Bertelle, V, Canning, R, Makary, H, Ojah, C, Monterrosa, L, Emberley, J, Afifi, J, Kajetanowicz, A & Lee, SK 2019, 'Neonates with a 10-min Apgar score of zero: Outcomes by gestational age', Resuscitation, vol. 143, pp. 77-84. https://doi.org/10.1016/j.resuscitation.2019.07.036

@article{29b901e971964014b7449ccfeb31adcf,

title = "Neonates with a 10-min Apgar score of zero: Outcomes by gestational age",

abstract = "Background: The current resuscitation guidelines for neonates recommend considering stopping resuscitation efforts if the heart rate remains undetectable after 10 min of adequate resuscitation. However, this recommendation does not take into account the gestational age (GA) of the neonates. We determined the outcomes of neonates with a 10-min Apgar score of zero (Apgar10 = 0) with respect to their GA. Methods: In a retrospective matched cohort study, we studied neonates admitted to the Canadian Neonatal Network NICUs between 2010 and 2016 with an Apgar10 = 0. The neonates were divided into 3 subgroups according to their GA: (1) ≥36 weeks{\textquoteright}, (2) 320/7–356/7 weeks{\textquoteright}, and (3) <32 weeks{\textquoteright}. Each neonate with Apgar10 = 0 was matched 1:1 with neonates of same GA and sex but Apgar10 = 1–2 and Apgar10 = 3–5. Survival and brain injury were compared between matched groups. Results: 177 neonates had Apgar10 = 0. Survival to discharge was significantly different between GA groups [≥36 weeks{\textquoteright} 61% vs. 320/7–356/7 weeks{\textquoteright} 58% vs. <32 weeks{\textquoteright} 35%, p = 0.04]. Survival to discharge was similar to their matched cohort with Apgar10 = 1–2 for neonates born at ≥36 weeks{\textquoteright} (61% vs. 66%) and between 320/7 to 356/7 weeks{\textquoteright} (58% vs. 54%), but significantly different for neonates <32 weeks (35% vs. 61%, p = 0.04). Conclusion: Neonates with Apgar10 = 0 had different outcomes depending on their GA. Less than half of neonates born at <32 weeks GA survived; however, a majority of neonates born at 320/7–356/7 weeks{\textquoteright} and ≥36 weeks{\textquoteright} GA survived at similar rates than their matched neonates with Apgar10 = 1–2.",

author = "Zhong, {You Jia} and Martine Claveau and Yoon, {Eugene W.} and Khalid Aziz and Nalini Singhal and Shah, {Prakesh S.} and Pia Wintermark and Jaideep Kanungo and Joseph Ting and Zenon Cieslak and Rebecca Sherlock and Wendy Yee and Jennifer Toye and Carlos Fajardo and Zarin Kalapesi and Koravangattu Sankaran and Sibasis Daspal and Mary Seshia and Ruben Alvaro and Amit Mukerji and {Da Silva}, Orlando and Chuks Nwaesei and Lee, {Kyong Soon} and Michael Dunn and Brigitte Lemyre and Kimberly Dow and Ermelinda Pelausa and Keith Barrington and Christine Drolet and Bruno Piedboeuf and Marc Beltempo and Valerie Bertelle and Roderick Canning and Hala Makary and Cecil Ojah and Luis Monterrosa and Julie Emberley and Jehier Afifi and Andrzej Kajetanowicz and Lee, {Shoo K.}",

note = "Funding Information: Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant ( CTP 87518 ), the Ontario Ministry of Health and in-kind support from Mount Sinai Hospital . Dr. Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Dr. Wintermark holds a FRSQ Clinical Research Scholar Career Awards Junior 2. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Funding Information: The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON for organizational support of CNN. In addition, we thank Sarah Hutchinson, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and in-kind support from Mount Sinai Hospital. Funding Information: Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (CTP 87518), the Ontario Ministry of Health and in-kind support from Mount Sinai Hospital. Dr. Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Dr. Wintermark holds a FRSQ Clinical Research Scholar Career Awards Junior 2. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON for organizational support of CNN. In addition, we thank Sarah Hutchinson, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and in-kind support from Mount Sinai Hospital. Publisher Copyright: {\textcopyright} 2019 Elsevier B.V.",

year = "2019",

month = oct,

doi = "10.1016/j.resuscitation.2019.07.036",

language = "English",

volume = "143",

pages = "77--84",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Neonates with a 10-min Apgar score of zero

T2 - Outcomes by gestational age

AU - Zhong, You Jia

AU - Claveau, Martine

AU - Yoon, Eugene W.

AU - Aziz, Khalid

AU - Singhal, Nalini

AU - Shah, Prakesh S.

AU - Wintermark, Pia

AU - Kanungo, Jaideep

AU - Ting, Joseph

AU - Cieslak, Zenon

AU - Sherlock, Rebecca

AU - Yee, Wendy

AU - Toye, Jennifer

AU - Fajardo, Carlos

AU - Kalapesi, Zarin

AU - Sankaran, Koravangattu

AU - Daspal, Sibasis

AU - Seshia, Mary

AU - Alvaro, Ruben

AU - Mukerji, Amit

AU - Da Silva, Orlando

AU - Nwaesei, Chuks

AU - Lee, Kyong Soon

AU - Dunn, Michael

AU - Lemyre, Brigitte

AU - Dow, Kimberly

AU - Pelausa, Ermelinda

AU - Barrington, Keith

AU - Drolet, Christine

AU - Piedboeuf, Bruno

AU - Beltempo, Marc

AU - Bertelle, Valerie

AU - Canning, Roderick

AU - Makary, Hala

AU - Ojah, Cecil

AU - Monterrosa, Luis

AU - Emberley, Julie

AU - Afifi, Jehier

AU - Kajetanowicz, Andrzej

AU - Lee, Shoo K.

N1 - Funding Information: Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant ( CTP 87518 ), the Ontario Ministry of Health and in-kind support from Mount Sinai Hospital . Dr. Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Dr. Wintermark holds a FRSQ Clinical Research Scholar Career Awards Junior 2. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Funding Information: The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON for organizational support of CNN. In addition, we thank Sarah Hutchinson, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and in-kind support from Mount Sinai Hospital. Funding Information: Although no specific funding has been received for this study, organizational support for the Canadian Neonatal Network was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (CTP 87518), the Ontario Ministry of Health and in-kind support from Mount Sinai Hospital. Dr. Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). Dr. Wintermark holds a FRSQ Clinical Research Scholar Career Awards Junior 2. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors gratefully acknowledge all site investigators and abstractors of the Canadian Neonatal Network (CNN). We thank the staff at the Maternal-Infant Care (MiCare) Research Centre at Mount Sinai Hospital, Toronto, ON for organizational support of CNN. In addition, we thank Sarah Hutchinson, PhD, from MiCare for editorial assistance in the preparation of this manuscript. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CTP 87518), the Ontario Ministry of Health, and in-kind support from Mount Sinai Hospital. Publisher Copyright: © 2019 Elsevier B.V.

PY - 2019/10

Y1 - 2019/10

N2 - Background: The current resuscitation guidelines for neonates recommend considering stopping resuscitation efforts if the heart rate remains undetectable after 10 min of adequate resuscitation. However, this recommendation does not take into account the gestational age (GA) of the neonates. We determined the outcomes of neonates with a 10-min Apgar score of zero (Apgar10 = 0) with respect to their GA. Methods: In a retrospective matched cohort study, we studied neonates admitted to the Canadian Neonatal Network NICUs between 2010 and 2016 with an Apgar10 = 0. The neonates were divided into 3 subgroups according to their GA: (1) ≥36 weeks’, (2) 320/7–356/7 weeks’, and (3) <32 weeks’. Each neonate with Apgar10 = 0 was matched 1:1 with neonates of same GA and sex but Apgar10 = 1–2 and Apgar10 = 3–5. Survival and brain injury were compared between matched groups. Results: 177 neonates had Apgar10 = 0. Survival to discharge was significantly different between GA groups [≥36 weeks’ 61% vs. 320/7–356/7 weeks’ 58% vs. <32 weeks’ 35%, p = 0.04]. Survival to discharge was similar to their matched cohort with Apgar10 = 1–2 for neonates born at ≥36 weeks’ (61% vs. 66%) and between 320/7 to 356/7 weeks’ (58% vs. 54%), but significantly different for neonates <32 weeks (35% vs. 61%, p = 0.04). Conclusion: Neonates with Apgar10 = 0 had different outcomes depending on their GA. Less than half of neonates born at <32 weeks GA survived; however, a majority of neonates born at 320/7–356/7 weeks’ and ≥36 weeks’ GA survived at similar rates than their matched neonates with Apgar10 = 1–2.

AB - Background: The current resuscitation guidelines for neonates recommend considering stopping resuscitation efforts if the heart rate remains undetectable after 10 min of adequate resuscitation. However, this recommendation does not take into account the gestational age (GA) of the neonates. We determined the outcomes of neonates with a 10-min Apgar score of zero (Apgar10 = 0) with respect to their GA. Methods: In a retrospective matched cohort study, we studied neonates admitted to the Canadian Neonatal Network NICUs between 2010 and 2016 with an Apgar10 = 0. The neonates were divided into 3 subgroups according to their GA: (1) ≥36 weeks’, (2) 320/7–356/7 weeks’, and (3) <32 weeks’. Each neonate with Apgar10 = 0 was matched 1:1 with neonates of same GA and sex but Apgar10 = 1–2 and Apgar10 = 3–5. Survival and brain injury were compared between matched groups. Results: 177 neonates had Apgar10 = 0. Survival to discharge was significantly different between GA groups [≥36 weeks’ 61% vs. 320/7–356/7 weeks’ 58% vs. <32 weeks’ 35%, p = 0.04]. Survival to discharge was similar to their matched cohort with Apgar10 = 1–2 for neonates born at ≥36 weeks’ (61% vs. 66%) and between 320/7 to 356/7 weeks’ (58% vs. 54%), but significantly different for neonates <32 weeks (35% vs. 61%, p = 0.04). Conclusion: Neonates with Apgar10 = 0 had different outcomes depending on their GA. Less than half of neonates born at <32 weeks GA survived; however, a majority of neonates born at 320/7–356/7 weeks’ and ≥36 weeks’ GA survived at similar rates than their matched neonates with Apgar10 = 1–2.

UR - http://www.scopus.com/inward/record.url?scp=85071132083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071132083&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2019.07.036

DO - 10.1016/j.resuscitation.2019.07.036

M3 - Article

C2 - 31421194

AN - SCOPUS:85071132083

SN - 0300-9572

VL - 143

SP - 77

EP - 84

JO - Resuscitation

JF - Resuscitation

ER -

Neonates with a 10-min Apgar score of zero: Outcomes by gestational age

Résumé

Note bibliographique

ASJC Scopus Subject Areas

PubMed: MeSH publication types

Accès au document

Autres fichiers et liens

Empreinte numérique

Citer