Abstract
Objective To determine the short-term outcomes (abnormal brain magnetic resonance imaging [MRI]/death)
in infants born with a 10-minute Apgar score of 0 who received therapeutic hypothermia
and compare them with infants with higher scores.
Study Design This is a retrospective review of 293 neonates (gestational age ≥ 35 weeks) born
between November 2006 and October 2015 admitted with hypoxic-ischemic encephalopathy
who received therapeutic hypothermia. Results of brain MRIs were assessed by the basal
ganglia/watershed scoring system. Short-term outcomes were compared between infants
with Apgar scores of 0, 1 to 4, and ≥5 at 10 minutes.
Results Eight of 17 infants (47%) with an Apgar of 0 at 10 minutes survived, having 4 (24%)
without abnormalities on the brain MRI and 7 (41%) without severe abnormalities. There
was no significant difference in the combined outcomes of “death/abnormal MRI” and
“death/severe abnormalities on the MRI” between infants with Apgar scores of 0 and
1 to 4. Follow-up data were available for six of eight surviving infants, and none
had moderate or severe neurodevelopmental impairment.
Conclusion In the cooling era, 47% of infants with no audible heart rate at 10 minutes and who
were admitted to the neonatal intensive care unit survived; 24% without abnormalities
on the brain MRI and 41% without severe abnormalities.
Keywords
Apgar 0 - neonatal encephalopathy - hypothermia - outcomes
