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Severe Perinatal Asphyxia and Apgar Scores-Reply

S. Davidson, MD; S. H. Reisner, MB, ChB
Am J Dis Child. 1987;141(12):1253. doi:10.1001/archpedi.1987.04460120015014.
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In Reply.—We thank Dr Jain for the comments on our article and for reraising the question of the correlation between Apgar score and neonatal asphyxia. We do agree that cord blood pH and base-deficit status at birth are better measurement tools than the Apgar score to indicate neonatal asphyxia.1 Unfortunately, in our study the cord blood gas measurements were available for only a small number of inborn infants and not for the whole group. As muscle tone and reflex irritability in low-birth-weight infants might be depressed simply because of neurologic immaturity, we have preferred to use the modified Apgar score2 that takes into account only three parameters of the original score (heart rate, respiration, and color). Thus, scores of 0, 1, or 2 were given, respectively, if respirations were absent, in gasps, or regular; if the heart rate was undetectable, less than 100 beats per minute, or


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