Noninferiority assessment of the “neonatal resuscitation and adaptation score” versus the Apgar score Original Research

Abstract

Introduction: Evaluation of the transition from the intrauterine environment in newborns is carried out with the Apgar score (1953), which provides a quick estimation of the clinical state; however, it contains subjective variables in its qualification. The new Neonatal Resuscitation and Adaptation score incorporates neonatal resuscitation interventions. The objective was to demonstrate the noninferiority of the new score compared to the Apgar score.

Methods: An observational, descriptive, cross-sectional study was carried out that used the two scores simultaneously. With a sample of 396 neonates. The univariate analysis used absolute and relative frequencies, and the bivarial analysis used ROC curves for diagnostic accuracy and statistical significance tests.

Results: The need for resuscitation was 35.6%, mechanical ventilation was 19.6%, and the diagnosis of asphyxia was 22%. The ROC curve that examined the variable asphyxia showed a Youden index in favor of the new score in the first and fifth minutes, with similar results in the variables mechanical ventilation and neonatal resuscitation.

Conclusion: The neonatal resuscitation and adaptation scores were not lower than the Apgar score in the assessment of asphyxia. Like its predecessor, it recognizes the need for resuscitation as well as the need for mechanical ventilation in neonates with low scores. It is a new tool with easy application and understanding for the determination of the transition state in newborns.