Associations between metabolic acidosis at birth and reduced Apgar scores within the normal range (7‐10): A Swedish cohort study of term non‐malformed infants
Bibliographic record
Abstract
BACKGROUND: Risks of neonatal and long-term neurological outcomes are influenced by metabolic acidosis at birth and by reduced Apgar scores, even within the normal range (7-10). OBJECTIVE: To analyse associations between metabolic acidosis at birth and risks of reduced Apgar scores within the normal range. METHODS: In a Swedish cohort of term non-malformed infants born between 2008 and 2013, we included 81 861 infants with information from cord blood gas analyses and Apgar score values of 7-10 at 1, 5, and 10 minutes. Poisson log-linear regression analyses were used to examine associations between metabolic acidosis at birth (defined as pH <7.05 or <7.10 and base deficit ≥12) and Apgar scores of 7, 8, and 9. Adjusted risk ratio (RR) and 95% confidence intervals (C). were calculated. RESULTS: Compared with infants without metabolic acidosis, the adjusted RR of an Apgar score of 9 at 5 minutes was 3.14 (95% CI 2.57, 3.84) in infants with metabolic acidosis (pH <7.05 as cut-off), and 10.13 (95% CI 7.63, 13.45) and 7.60 (95% CI 3.54, 16.33) for Apgar scores of 8 and 7, respectively. Corresponding RRs of Apgar scores at 10 minutes were also substantially increased. The magnitude of RDs varied, but was consistently increased. Both reduced Apgar scores and metabolic acidosis (pH <7.10) influenced neonatal morbidity. CONCLUSIONS: Metabolic acidosis is associated with increased risks of reduced Apgar scores within the normal range. Due to international variations in the assessment of Apgar score, our findings need to be confirmed in other populations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".