Apgar scores for a preemie

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Re : Apgar scores for a preemie

Post by season » Fri Nov 06, 2009 02:51 pm

Hallie - I'm sorry that seeing these records is bringing anxiety up for you surrounding her birth. I think all preemie parents live with doubts about the effects of prematurity on our children.

Apgar scores are determined by evaluating the newborn baby on five simple criteria Appearance, Pulse, Grimace, Activity, Respiration. Thus allowing the doctors to then know if a newborn needs assistance. Because preemies are not fully mature and often need assistance with breathing and temperature regulation etc- I believe it is common for their scores to be low.
It's like giving a 2nd grade math test to a kindergartner - it clearly shows the child does not yet know those skills - not that the child won't be able to obtain them.

My preemie's apgars were surprisingly high yet later he showed distress and needed intubation. So, as stated by others, high or low apgars are only an indication of how the infant is doing right at that moment - allowing the doctors to make decision on what intervention may be needed.

Re : Apgar scores for a preemie

Post by kara » Fri Nov 06, 2009 02:37 pm

Crystal, excellent point about the purpose of apgars determining the level of support needed. I couldn't see much when Avery was born, except that she was completely silent, still and floppy, and a very dark blue/purple from tip to toes. They worked on her for quite awhile at my bedside, perhaps even before they cut the cord. Once they handed her to the nicu staff for transport she had pinked up and I knew then that she was ok for the short term at least. It's scary for all of us with preemies, regardless of immediate complications.

Re : Apgar scores for a preemie

Post by crystalw » Fri Nov 06, 2009 08:54 am

0 Kara!? How scary :( I'm glad they brought her back! Addison was born at 27 weeks and she was a 9-9 I think? I couldn't believe it but she was breathing and crying and all that good stuff. I used to do the APGARS when I worked in the nursery and the lowest I gave was a 2? and it was scary :( Anyhow I'm trying to remember the scoring.. I know 2 for breathing 2 for heartrate 2 for tone 2 for color and 2 for grimace.

This is what I found about the reason for the APGAR : If the Apgar score remains below 3 at later times such as 10, 15, or 30 minutes, there is a risk that the child will suffer longer-term neurological damage. There is also a small but significant increase of the risk of cerebral palsy. However, the purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care; it was not designed to make long-term predictions on a child's health.[1]

Re : Apgar scores for a preemie

Post by jenn » Thu Nov 05, 2009 07:15 pm

Reading those scores seems very scary. Though I have found through my own personal experience that they don't necessarily mean anything later in life. I believe the doctors use them more as a gauge during delivery and their NICU stay more than anything.
Jaidyn was born at the same gestation as Gabbie and Jaidyn's scores were 6 and 8 I later learned. Those sound pretty good to me all things considered.
But in reality the scores mean nada' to me today.
Jaidyn has a laundry list of disabilities that include:
Learning disabilities (she's in special ed, 3rd grader that functions at a 1 st grade level)
Cerebral Palsy (Ataxic form, w/ hypotonia in all extremities)
Feeding issues
Failure to thrive issues
Auditory Possessing disorder
Sensory Integration
not dx yet , but most likely dyslexia

Preemies are like snowflakes, not one of them is exactly alike.
It's GREAT to know that Gabbie still continues to knock off socks despite her entrance into this world.
Based on how well she's doing - I wouldn't read too much into the apgar scores :o)
I send my best - Jenn

Re : Apgar scores for a preemie

Post by tracym » Thu Nov 05, 2009 05:49 pm

Jack's 1m was 3 and 5m was 8 at 37 weeks. He was resuscitated at delivery (he crashed during induction so he was a c-section under a general). He's 8 now and has never had any significant delays that required intervention.

Kate's were 8 & 9 at 33 weeks...came out screaming her lungs out. What a difference delivery of a non stressed baby makes!

Re : Apgar scores for a preemie

Post by kara » Thu Nov 05, 2009 05:23 pm

Avery was resecutated at birth. She scored a 0 and then a 4. I'm not sure what times were associated with those scores. Avery has sensory processing disorder, but she also had a heart defect that I suppose could have contributed. With a pretty premature birth, like our girls had, it's probably pretty common to have the low apgars. Them not telling you would probably not mean anything. We weren't told either, it was in our records. Your new doc was probably just asking for knowledge sake. I found all kinds of stuff - most of us do. ANd then when I had a consult about what happened with an MFM, I found out even more, like the placental abruption.

In emergency situations like ours, they can only respond to what is going on and do their best with what we present to them. Craziness!

Re : Apgar scores for a preemie

Post by mommiesangel » Thu Nov 05, 2009 04:26 pm

She wasn't breathing when the did the emergency c-section. I also found out a ton more stuff that makes me even more angry but I can't go into details till we decide what we are going to do :0X There was no equal score on the paperwrk I was given.

Thank you! She is our special mircle baby and several people were watching over us the day she was born.

Re : Apgar scores for a preemie

Post by amanda » Thu Nov 05, 2009 03:36 pm

Remind me again - was Gabrielle breathing on her own at birth or did they have to 'get her going'? There are some other items that combine to equal the score - do you know what they are? If not, I can find them.

I'm not sure that it matters at this point though - Gabrielle is a thriving 2 year old! I know it's scary though to see things like that and wonder. If you want I'll find the information for you!

I still think Gabrielle is the most adorable child I have ever seen. :)

Apgar scores for a preemie

Post by mommiesangel » Thu Nov 05, 2009 03:31 pm

I just got my report from the birth of Gabrielle in June 07 from my new OB. She had explained to me that Gabrielle scored a 1 at one minute, 1 at five minutes and 7 at ten minutes & asked if we noticed anything in her development. As far as DH, I & our pedi is aware no (though they don't have the records showing the scores above). Has anyone else's preemie had these scores and noticed any issues?