Earlier Apgar score increase in severely depressed term infants cared for in Swedish level III units with 40% oxygen versus 100% oxygen resuscitation strategies: a population-based register study.

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@article{477eb8124345455589833ea5cadeba74,
title = "Earlier Apgar score increase in severely depressed term infants cared for in Swedish level III units with 40{\%} oxygen versus 100{\%} oxygen resuscitation strategies: a population-based register study.",
abstract = "OBJECTIVES. The aim of this study was to evaluate whether a resuscitation strategy based on administration of 40{\%} oxygen influences mortality rates and rates of improvement in 5-minute Apgar scores, compared with a strategy based on 100{\%} oxygen administration. METHODS. A population-based study evaluated data from 4 Swedish perinatal level III centers during the period of 1998 to 2003. During this period, the centers used either of 2 resuscitation strategies (initial oxygen administration of 40{\%} or 100{\%}). Live-born, singleton, term infants with 1-minute Apgar scores of < 4, with a birth weight appropriate for gestational age, and without major malformations were included in the study (n = 1223). RESULTS. Infants born in hospitals using a 40{\%} oxygen strategy had a more rapid Apgar score increase than did infants born in hospitals using a 100{\%} oxygen strategy; however, no difference remained at 10 minutes. The mean Apgar score increased from 2.01 at 1 minute to 6.74 at 5 minutes in the 2 hospitals initiating resuscitation with 40{\%} oxygen, compared with 2.01 to 6.38 in the 2 hospitals using 100{\%} oxygen, with a mean difference in Apgar score increases of 0.36. At 5 minutes, 44.3{\%} of infants born in the hospitals using 100{\%} oxygen had an Apgar score of < 7, compared with 34.0{\%} of infants at the hospitals using 40{\%} oxygen. At 10 minutes, the mean Apgar scores were 8.16 at the hospitals using 40{\%} oxygen and 8.07 at the hospitals using 100{\%} oxygen. There were no significant differences in rates of neonatal death, hypoxic ischemic encephalopathy, or seizures in relation to the 2 oxygen strategies. CONCLUSION. Severely depressed term infants born in hospitals initiating resuscitation with 40{\%} oxygen had earlier Apgar score recovery than did infants born in hospitals using a 100{\%} oxygen strategy.",
keywords = "Resuscitation: methods, Registries, Newborn, Infant, Humans, Apgar Score, Oxygen: administration & dosage, Diseases: therapy, Severity of Illness Index, Sweden, Time Factors",
author = "Lena Hellstr{\"o}m-Westas and Kristina Forsblad and Gunnar Sjors and Saugstad, {Ola Didrik} and Lars Bj{\"o}rklund and Karel Marsal and Karin K{\"a}ll{\'e}n",
year = "2006",
doi = "10.1542/peds.2006-0102",
language = "English",
volume = "118",
pages = "E1798--E1804",
journal = "Pediatrics",
issn = "1098-4275",
publisher = "American Academy of Pediatrics",
number = "6",

}