Study of the Neonatal Resuscitation and Adaptation Score (NRAS) Compared to the Apgar Score in Neonatal Resuscitation

Main Article Content

Aya Mohamed Abd Elglil
Ashraf Mohamed Ibrahim
Nihal Salah Shihab
Abd El Rahman Mohamed El Mashad

Abstract

Introduction: The Neonatal Resuscitation and Adaptation Score (NRAS) was developed to address the concerns regarding how resuscitation impacts the Apgar score and how it can be accounted for in the scoring assessment.

Aims: The objective of this work was to compare between the Neonatal Resuscitation and Adaptation Score (NRAS) and the Apgar score, to determine the correlation between the two scoring systems, and their predictive ability for mortality and short-term morbidities.               

Methodology: This study was a prospective cohort study. It was carried out on 410 neonates in Tanta University Hospital. Both Apgar and NRAS scores were recorded for all cases at 1st and 5th minutes of life. The scores were divided into three categories: Low (0-3), Middle (4-6), High (7-10). All neonates were followed up for 48 hours. Correlation between both scores and neonatal outcome were recorded.

Results: There was a significant positive correlation between Apgar and NRAS scores at both 1st and 5th minutes. NRAS score was more précised in discriminating neonatal admissions, mortality, need for respiratory support and morbidities than Apgar score at both 1st and 5th minutes. The regression model revealed that Apgar 5th min and both of NRAS 1st and 5th minutes were significant predictors for neonatal mortality and morbidities. The most significant predictor was NRAS 1st min.

Conclusion: Both scores can be used in assessing the neonatal condition. The most significant predictor for neonatal mortality and morbidities was NRAS 1st min.

Keywords:
Apgar score, NRAS, neonatal resuscitation, mortality and morbidities

Article Details

How to Cite
Elglil, A. M. A., Ibrahim, A. M., Shihab, N. S., & Mashad, A. E. R. M. E. (2020). Study of the Neonatal Resuscitation and Adaptation Score (NRAS) Compared to the Apgar Score in Neonatal Resuscitation. Journal of Advances in Medicine and Medical Research, 32(24), 100-110. https://doi.org/10.9734/jammr/2020/v32i2430757
Section
Original Research Article

References

Kattwinkel J, Perlman JM, Aziz K et al. Neonatal resuscitation: American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care.Circulation. 2010;122: 909-11.

Apgar V: A proposal for a new method of evaluation of the newborn. Classic Papers in Critical Care. 1952;32:449-97.

Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants. New England Journal of Medicine. 2001;344(7): 467-71.

Jurdi MD, Archana MB, Adam P et al. Evaluation of a comprehensive delivery room neonatal resuscitation and adaptation score (NRAS) compared to the apgar score: A pilot study. Global Pediatric Health. 2015;2:1–8.

Witcher TJ, Jurdi S, Kumar V et al. Neonatal resuscitation and adaptation score vs apgar: Newborn assessment and predictive ability. Journal of Perinatology. 2018;38(11):1476-82.

Rüdiger M, Braun N, Aranda J et al. Neonatal assessment in the delivery room–Trial to Evaluate a Specified Type of Apgar (TEST-Apgar). BMC paediatrics. 2015;15(1):18.

Catlin EA, Carpenter MW, Brann IV BS et al. The Apgar score revisited: Influence of gestational age. The Journal of Paediatrics. 1986;109(5):865-8.

Li F, Wu T, Lei X et al. The Apgar score and infant mortality. PloS one. 2013;8(7).

Yang C, Chen X, Zu S et al. Retrospective analysis of risk factors for low 1-minute Apgar scores in term neonates. Brazilian Journal of Medical and Biological Research. 2019;52(12).

Salustiano EMA, Campos JADB, Ibidi SM et al. Baixos índices de Apgar no quinto minuto de vida em população de baixo risco: Fatores maternos e obstétricos e resultados pós-natais. Revista da Associação Médica Brasileira. 2012;58(5): 587-93.

Drage JS, Kennedy C, and Schwarz BK. The Apgar score as an index of neonatal mortality: A report from the Collaborative Study of Cerebral Palsy. Obstetrics & Gynecology. 1964; 24(2):222-30.

Razaz N, Cnattingius S, Persson M et al. One-minute and five-minute Apgar scores and child developmental health at 5 years of age: A population-based cohort study in British Columbia, Canada. BMJ open. 2019;9(5).