Objective To investigate associations between Apgar score at five and 10 minutes across the entire range of score values (from 0 to 10) and risks of childhood cerebral palsy or epilepsy, and to analyse the effect of changes in Apgar scores from five to 10 minutes after birth in infants born ≥37 completed weeks.
Design, setting, and participants Population based cohort study in Sweden, including 1 213 470 non-malformed live singleton infants, born at term between 1999 and 2012. Data on maternal and pregnancy characteristics and diagnoses of cerebral palsy and epilepsy were obtained by individual record linkages of nationwide Swedish registries.
Exposures Apgar scores at five and 10 minutes.
Main outcome measure Cerebral palsy and epilepsy diagnosed up to 16 years of age. Adjusted hazard ratios were calculated, along with 95% confidence intervals.
Results 1221 (0.1%) children were diagnosed as having cerebral palsy and 3975 (0.3%) as having epilepsy. Compared with children with an Apgar score of 10 at five minutes, the adjusted hazard ratio for cerebral palsy increased steadily with decreasing Apgar score: from 1.9 (95% confidence interval 1.6 to 2.2) for an Apgar score of 9 to 277.7 (154.4 to 499.5) for an Apgar score of 0. Similar and even stronger associations were obtained between Apgar scores at 10 minutes and cerebral palsy. Associations between Apgar scores and epilepsy were less pronounced, but increased hazard ratios were noted in infants with a five minute Apgar score of 7 or less and a 10 minute Apgar score of 8 or less. Compared with infants with an Apgar of 9-10 at both five and 10 minutes, hazard ratios of cerebral palsy and epilepsy were higher among infants with a five minute Apgar score of 7-8 and a 10 minute Apgar score of 9-10.
Conclusion Risks of cerebral palsy and epilepsy are inversely associated with five minute and 10 minute Apgar scores across the entire range of Apgar scores.

中文翻译：

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五分钟和十分钟的Apgar评分以及脑瘫和癫痫的风险：瑞典基于人群的队列研究

目的探讨在整个评分值范围（从0到10）中，五到十分钟的Apgar评分与儿童脑瘫或癫痫风险之间的关系，并分析五到十分钟后Apgar评分变化的影响出生≥37周的婴儿出生。
设计，地点和参与者在瑞典进行的基于人口的队列研究，包括1 213 470例未畸形的活产单胎婴儿，出生于1999年至2012年之间。通过个人记录获得了母体和妊娠特征以及脑瘫和癫痫的诊断数据瑞典全国注册管理机构之间的联系。
暴露Apgar在5分钟和10分钟时得分。
主要结果指标诊断为脑瘫和癫痫病的年龄不超过16岁。计算了调整后的危险比以及95％的置信区间。
结果被诊断为脑瘫的儿童为1221名（0.1％），患有癫痫病的儿童为3975名（0.3％）。与五分钟Apgar得分为10的儿童相比，调整后的脑瘫危险比随着Apgar得分的降低而稳步上升：Apgar得分从9到277.7（从154.4到499.5）从1.9（95％置信区间1.6到2.2）。 ）的Apgar得分为0。在10分钟的Apgar得分与脑瘫之间获得了相似甚至更强的关联。Apgar评分与癫痫之间的关联不太明显，但在五分钟Apgar评分为7或以下且10分钟Apgar评分为8或以下的婴儿中发现了较高的危险比。与5分钟和10分钟Apgar为9-10的婴儿相比，
结论脑瘫和癫痫的风险与整个Apgar评分范围的5分钟和10分钟Apgar评分呈负相关。