When a baby is born, a physician or nurse immediately examines him or her and calculates what is called an Apgar score, which is a measure of how healthy the baby is. A new study has found that this score may also be a useful tool for predicting whether the baby's mother is critically ill.
There are other tools used to assess the risk of illness on the part of the mother - whether she is ill enough to need of transfer to an intensive care unit (ICU) - but none have taken into account the health of her baby.
Researchers at St. Michael's Hospital in Toronto and the University of Toronto examined health records of more than 600,000 live births in Ontario between 2006 and 2012. They found a strong relation between a baby's Apgar score and whether its mother was admitted to ICU after delivery. An Apgar score awards two points each for appearance (skin color), pulse (heart rate), grimace response (reflexes), activity (muscle tone), and respiration (breathing rate and effort) of the newborn at one minute and five minutes after birth. A normal score is 7 or higher, an intermediate score is 4 to 6, and a low score is 0 to 3.
The researchers found that among mothers whose baby had a normal Apgar score five minutes after birth, 1.7 per 1,000 of the women were admitted to an ICU. When the Apgar score was in the intermediate range, 12.3 of every 1,000 mothers were admitted to an ICU. When the Apgar score was low, the mother's rate of ICU admission rose to 18.2 per 1,000.
Mothers whose babies had a low Apgar score had nine times the risk of ICU admission than those whose baby had a normal Apgar, even after taking into account the mother's age, number of previous deliveries, economic status, and whether she had certain health conditions. Mothers of babies with intermediate Apgar score had a 6.5-times higher risk of going to an ICU than those who had a normal Apgar.
Most maternal ICU admissions are due to complications such as heavy bleeding after delivery, serious pre-eclampsia (high blood pressure), or after an emergency hysterectomy.
