Study of the Neonatal Resuscitation and Adaptation Score (NRAS) Compared to the Apgar Score in Neonatal Resuscitation

Abstract

Introduction: The Neonatal Resuscitation and Adaptation Score (NRAS) was developed to address the concerns regarding how resuscitation impacts the Apgar score and how it can be accounted for in the scoring assessment. Aims: The objective of this work was to compare between the Neonatal Resuscitation and Adaptation Score (NRAS) and the Apgar score, to determine the correlation between the two scoring systems, and their predictive ability for mortality and short-term morbidities.                Methodology: This study was a prospective cohort study. It was carried out on 410 neonates in Tanta University Hospital. Both Apgar and NRAS scores were recorded for all cases at 1st and 5th minutes of life. The scores were divided into three categories: Low (0-3), Middle (4-6), High (7-10). All neonates were followed up for 48 hours. Correlation between both scores and neonatal outcome were recorded. Results: There was a significant positive correlation between Apgar and NRAS scores at both 1st and 5th minutes. NRAS score was more précised in discriminating neonatal admissions, mortality, need for respiratory support and morbidities than Apgar score at both 1st and 5th minutes. The regression model revealed that Apgar 5th min and both of NRAS 1st and 5th minutes were significant predictors for neonatal mortality and morbidities. The most significant predictor was NRAS 1st min. Conclusion: Both scores can be used in assessing the neonatal condition. The most significant predictor for neonatal mortality and morbidities was NRAS 1st min.