Apgar Scores as Predictors of Chronic Neurologic Disability, by Karin B. Nelson, MD, and Jonas H. Ellenberg, PhD,Pediatrics, 1981;68:36–44

Apgar scores were recorded at one and five minutes for ∼49 000 infants, and at 10, 15, and 20 minutes for babies who did not achieve a score of 8 or higher at five minutes. These children were followed to 7 years of age. Low Apgar scores were risk factors for cerebral palsy, but 55% of children with later cerebral palsy had Apgar scores of 7 to 10 at one minute, and 73% scored 7 to 10 at five minutes. Of 99 children who had Apgar scores of 0 to 3 at 10, 15, or 20 minutes and survived, 12 (12%) had later cerebral palsy; 11 of the 12 also were mentally retarded (in 10, IQ <50) and half had seizure disorders. Eight children who survived after having very low late Apgar scores and who did not have cerebral palsy had lesser but significant disabilities. Of the children who had Apgar scores of 0 to 3 at 10 minutes or later and survived, 80% were free of major handicap at early school age.