Physicians have debated the relationship between a low APGAR score and cerebral palsy, especially in children with low birth weight. Although this relationship has previously been inconclusive, a new study by the Norwegian Institute of Public Health (NIPH) indicates a direct association between cerebral palsy and low APGAR scores in children with less than normal birth weights.
What is an APGAR score?
The APGAR test is a newborn assessment given directly after birth that measures five criteria to determine the child's health:
- Appearance/skin color - pink, pale or blue
- Pulse - Is it above or below 100 beats per minute?
- Grimace - Does the child cry or pull away when stimulated?
- Activity - Do the child's arms and legs resist extension?
- Respiration - Is there a strong, healthy cry?
Points are given based on the strength of each element. Scores between seven and 10 are considered normal. Scores between zero and six are considered low. In an interview with healthcanal.com, researcher Kari Kveim Lie of the NIPH indicated that between 10 and 17 percent of newborns with very low APGAR scores developed cerebral palsy.
How the Results Were Interpreted
A low APGAR score suggests that the child had oxygen deficiencies during birth, which may have been caused by a birth injury, but other factors may contribute to low vitality. For example, a problem with the child's nervous system would definitely affect responsiveness. A low score could also be a sign of brain damage, which also can cause cerebral palsy. However, a brain injury could have occurred during pregnancy just as it could during the birth. As such, the researchers could not determine whether birth-related brain damage, as opposed to prenatal damage, caused cerebral palsy in the subject babies.
Nevertheless, if a newborn has a low birth weight and low APGAR score, physicians would be more likely to monitor the child to determine if breathing problems persist, whether other nervous system issues exist or if the child has, or will develop, cerebral palsy. Both elements are helpful in determining how the physician will proceed in helping the child adjust to the outside world.
