Sir.—I read with interest the article by Davidson et al1 evaluating β-endorphin levels in low-birth-weight infants. The authors define severe perinatal asphyxia as "a one-minute Apgar score of 0 to 2 or the necessity at birth of positive pressure ventilation." A score of 3 to 4 was classified as mild to moderate asphyxia.
Numerous studies have shown that a low one-minute score does not correlate to either asphyxia or future outcome.2 Even a five-minute score of 0 to 3, although possibly due to hypoxia, has been shown to have limited value in this regard. Low-birth-weight infants studied by others have been shown to have low scores at birth secondary to neurologic immaturity without any evidence of asphyxia.3 A recent statement of the American Academy of Pediatrics2 on the use and misuse of Apgar scores states that because scores at one and five minutes have poor
Jain L. Severe Perinatal Asphyxia and Apgar Scores. Am J Dis Child. 1987;141(12):1253. doi:10.1001/archpedi.1987.04460120015013