![]() ![]() ![]() We did not observe any major modifying effects of gestational age and sex, although there seems to be substantial confounding by gestational age and birth weight on the observed association. This study suggests that low Apgar score is associated with higher risk of ASD, and in particular AD. The point estimates for low (RR, 1.88 95% CI, 1.41–2.51) and intermediate Apgar score (RR, 1.54 95% CI, 1.32–1.81) were larger for AD than for ASD. In fully adjusted models, low Apgar scores (1–3) (RR, 1.42 95% CI, 1.16–1.74), and intermediate Apgar scores (4–6) (RR, 1.50 95% CI, 1.36–1.65) were associated with a higher RR of ASD than optimal Apgar score (7–10). We used interaction terms and stratified analysis to investigate the effects of sex, gestational age, and birth weight on the association. All analyses for ASD were repeated for autistic disorder (AD). We calculated crude and adjusted risk ratios (RR) with 95% confidence intervals (95% CIs) for the associations between low Apgar score and ASD. We included prospective data from 5.5 million individuals and over 33,000 cases of ASD from Norway, Sweden, Denmark and Western Australia who were born between 19. We aimed to investigate (1) the association between low Apgar score at 5 min and risk for ASD, and (2) the modifying effects of gestational age and sex on this association in the largest multinational database of ASD. Studies of the association between Apgar score and autism spectrum disorder (ASD) have been inconsistent. ![]() Low Apgar score has been associated with higher risk for several neurological and psychiatric disorders, including cerebral palsy and intellectual disability. ![]()
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