Purpose: The proposed research will investigate possible racial difference in the association between one and five-minute Apgar scores and mortality and early morbidity among low birthweight infants during the initial hospitalization period.
Specific Aims : This research will examine any differences found between black and white low birthweight infants in the association between Apgar scores and survival, length of hospital stay, need for resuscitation, lengt of ventilation and incidence of neonatal seizures and/or intraventricular hemorrhage. Study Design and Population: The study design will be a historic cohort design. The study population will consist of all low-birthweight infants (<2500 g) born in a five-year period at Christiana Hospital of the Medical Center of Delaware in Stanton, Delaware. It is estimated that approximatel 10% of the over 6000 deliveries each year at Christiana Hospital are low birthweight, roughly evenly divided between black and white infants. This will yield a study sample of roughly 1500 black infants and 1500 white infants. Data will be collected by review of medical records. Significance: Apgar scores have become accepted world-wide as the standard for newborn evaluation but have a different meaning in low birthweight infants than in full-term newborns although assigned the same way. Critica treatment decisions concerning resuscitation and transport are often based on Apgar scores and several newborn care protocols include treatment recommendations based on them. With increased numbers of low birthweight infants, the benefits and potential risks of newborn resuscitatory and ventilatory support need to be investigated for their role in intraventricular hemorrhage and other conditions, which are both serious an common, especially in premature infants.
