Influence of Parental Race on Apgar Scores [19R]

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Dr. Virginia Apgar in 1953 commented that the scoring for skin color is “by far the most unsatisfactory sign.” The objective of this study was to assess the impact of parental race on 5-minute Apgar scores.


Retrospective review of the National Vital Statistic System birth data of singleton live term births from 2009–2013. The study population was divided into 3 groups: Group 1: Both parents non-Hispanic (nH) white Group 2: Both parents nH black Group 3: One parent nH white and the other parent nH black.


Total of 9,316,918 births. There were 81.4% (n=7,587,238) in group 1, 14.8% (n=1,374,256) in group 2 and 3.8% (n=355,424) in group 3. Infants born to parents in group 1 were nearly twice as likely to have a 5 minute Apgar score of 10 as compared to those in group 2 and nearly 50% more likely to have an Apgar score of 10 when compared to those on group 3 (4.6% vs 2.2% vs 3.2%, P=.05).


Our findings confirm Dr. Apgar's initial observation made over 60 years ago. In our cohort, infants born to nH black parents are significantly less likely to have an Apgar score of 10 than those born to nH white parents. The difference was made up by with a higher proportion of a 5-minute Apgar score of 9, and had no impact on Apgar scores of 7 and 8. The overall lower percentage of a 5-minute Apgar score of 10 among nH black newborns appears to have no clinical implications.

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