Relationship between Apgar scores and long-term cognitive outcomes in individuals with Down syndrome

Abstract

This study examined the contribution of the Apgar score at 1 and 5 min after birth to later cognitive functioning in 168 individuals with Down syndrome who were between 6 and 25 years of age at time of cognitive testing. Our results showed that a lower Apgar score at 1 min was related to a worse performance in later cognitive measures of receptive vocabulary, verbal comprehension and production, visual memory and working memory. Results also showed that a lower Apgar score at 5 min was only related to worse later outcomes of verbal comprehension and production and auditory working memory. Our findings suggest a need for future studies investigating how specific perinatal events reflected in the Apgar score are linked to later cognitive functioning in individuals with Down syndrome.

Figure 1

Spaghetti plot representing Apgar score trajectory from one to five minutes after birth in each participant with DS. Each line represents a participant with DS. Several trajectories overlap between them.

Figure 2

Partial regression plots representing the association between the Apgar score at 1 min (x-axis) and the following dependent variables (y-axis) from the top left to the bottom right: Riddles, Recall of Digits Forward, PAL(first trial memory score) and Verbal Knowledge, while adjusting for chronological age (CA) at time of cognitive testing. See that the score on cognitive variables (Y) increases as Apgar score (X₁) increases adjusting for chronological age (X2). PAL paired-associates learning.

Figure 3

Partial regression plots representing the association between the Apgar score at 5 min (x-axis) and the following dependent variables (y-axis): Riddles and Recall of Digits Forward (total correct), while adjusting for chronological age (CA) at time of cognitive testing. See that the score on cognitive variables (Y) increases as Apgar score (X₁) increases adjusting for chronological age (X2).