Improving neonatal care by advancing the Apgar scoring system

Grünebaum et al’s1Grünebaum A. Is it time to modify the Apgar score?.Am J Obstet Gynecol. 2023; Abstract Full Text PDF Scopus (0) Google Scholar perspective “Is score?,” written in response our article, “Associations between provider-assigned score and neonatal race,” was thought-provoking a step right direction.2Edwards S.E. Wheatley C. Sutherland M. Class Q.A. Associations race.Am 228: 229.e1-229.e9Abstract PubMed (1) Our study demonstrated that providers assigned lower scores Black neonates than non-Black when controlling for other factors (ie, umbilical cord gases, gestational age, maternal fetal complications). This difference seemed be driven by on their color subscore. However, did not seem clinically indicated may have contributed increased intensive care stays these offspring.2Edwards In colleagues1Grünebaum assert stem from inherent flaws scoring system. The authors further argue continued use of violates Section 1557 Patient Protection Affordable Care Act, which mandates nondiscrimination clinical algorithms. We concur with subscore beneficial neonates. As they point out, creator herself recognized limitations.3Apgar V. A proposal new method evaluation newborn infant.Curr Res Anesth Analg. 1953; 32: 260-267Crossref encourage replication study, we are eager read about crucial examinations benefit Furthermore, future research extent inaccurately low caused individual provider bias or algorithm is needed. hope article call-to-action speed this area. Physicians should seek provide unbiased address issue urgency. rightly out additional urgency mandated whose legal obligation eliminate discriminatory algorithms would certainly apply here. Given more objective tools, such as pulse oximetry, also been racially biased,4Valbuena V.S.M. Merchant R.M. Hough C.L. Racial ethnic oximetry outcomes.JAMA Intern Med. 2022; 182: 699-700Crossref (8) agree suggestion replace current version without score?American Journal Obstetrics & GynecologyPreviewWe interest publication race” Edwards al.1 reported significantly scores, were scores. Full-term admitted unit (NICU) at higher rates confounders (eg, artery blood gases pH, maternal-fetal Full-Text