Low Apgar Scores and Medical Malpractice during Delivery

The Apgar test is a test given to all newborns at one minute and five minutes after birth. The test provides a general overview of the infant’s health. The first score assesses how well the infant survived the birth process and the second indicates how well the infant is adapting to life outside the mother’s womb.

Each of the 5 characteristics tested for receives a score between zero and two. Low Apgar scores, which are any score lower than a seven, require immediate medical attention. For some infants, this low score may signify a serious problem. Some studies suggest that low Apgar scores in the early minutes of life could be an indication of a child’s diminished quality of life many years later.

Apgar scores evaluate five basic characteristics:

• A – Appearance, assesses whether the infant’s skin is blue or a healthy pink color
• P – Pulse rate, which is calculated according to heartbeats per minute
• G – Grimace response evaluates responses to stimulation
• A – Activity rates the amount of movement the baby is making
• R – Respiration indicates how well the baby is breathing

Causes of low Apgar scores

There are a number of reasons why an Apgar score might be low, including a difficult birth. Other factors that can affect the Apgar score include a C-section and fluid in the baby’s lungs. Most issues can be addressed immediately at birth, which is why the majority of low scores at one minute go up significantly by the five-minute mark. When scores remain low, Apgar scores may continue to be taken until the baby’s condition improves.

Apgar and cerebral palsy

A study published in the British Medical Journal in 2010 found a “strong” association between low Apgar scores and cerebral palsy. Researchers compared records of babies born in Norway between 1986 and 1995 with the Norwegian Registry of Cerebral Palsy in Children born during the same years. They found that 11 percent of children with Apgar scores of three or lower five minutes after birth were diagnosed with cerebral palsy, versus 0.1 percent of children with Apgar scores of 10. The association was higher in babies born with normal birth weight and moderate for those with low birth weight.

Apgar and ADHD

Another study published in The Journal of Pediatrics in 2011 found that babies with a lower Apgar score were also more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) in childhood. The researchers in this study looked at more than 980,000 children born in Denmark between 1988 and 2001. They found the risk of ADHD was 75 percent higher in children with Apgar scores of 1-4 than those with scores of 9-10. Children with Apgar scores of 5-6 were 63 percent more likely to be diagnosed with ADHD than children with higher scores.

Apgar and medical malpractice

If low Apgar scores are a result of malpractice or negligence in the delivery room, the consequences can be life-changing for both the child and the parents. Mistakes that lead to oxygen deprivation of the baby can result in brain damage, permanent injury and even death. Parents that face these tragic circumstances may have ground for legal action against the hospital and staff that failed to provide them appropriate care.

When malpractice can be proven in these cases, families may be entitled to compensation from the hospital for medical bills, pain and suffering and other non-economic losses. While a favorable verdict will not change their child’s situation, it can make it easier for the parents to provide the care the child may require for a lifetime.

Resources Resources