Source: Journal Pediatrics, 2011.
A recent study by Danish researchers of the Department of Epidemiology, School of Public Health, University of Aarhus, concludes that a low Apgar score is associated with an increased risk of ADHD in childhood. What does it all mean?
The Apgar score was devised in 1952 by Dr. Virginia Apgar (an anesthesiologist) to simply and repeatably assess the health of a newborn in the delivery room. While it has come under question in some circles as to whether an Apgar score means anything at all, the score is a subjective number assignment (0 to 10) of Appearance (color, etc.), Pulse, Grimace (facial movements or crying), Activity (movement) and Respiration (breathing). It is usually taken at 5 minutes of life. And repeated.
While it is clear that a score of zero is incompatible with describing life, it is debatable what a low Apgar score (say a 4) means to an infant’s future development. It is after all their first graded test.
Enter the Danes. The researchers decided to determine whether low Apgar scores at 5 minutes are associated with increased risks of attention deficit hyperactivity disorder (ADHD) in the future. The study was a nationwide (Denmark for the Euro-ignorant) population-based cohort study of 980,902 babies born in Denmark from 1988 to 2001. All children were monitored from 3 years of age until a first International Classification of Diseases diagnosis of hyperkinetic disorder, a first medication for ADHD, migration, death, or the end of 2006, whichever came first.
Their results? Compared with children with Apgar scores of 9 or 10 at 5 minutes, the risk for ADHD was 75% higher in children with Apgar scores of 1 to 4 (hazard ratio 1.75; 95% CI: 1.15-2.11) and 63% higher for those with Apgar scores of 5 to 6 (95% CI: 1.25-2.11). Consider that 5% of all children are diagnosed with the disorder.
But why? There the research is not as complete. Speculation includes: poor maternal nutrition and prenatal (prior to birth) medical care; asphyxia (lack of oxygen); small brain hemorrhage; shock or trauma -any one of which could result in a subjectively lower score by the observer.
Post: David M. Schwadron, Esquire