Dr. Ikonen of Finland sent Apgar a copy of his doctoral thesis, the topic of which was the Apgar score. In this response,
Apgar reflected on the expectations that had grown around the score since she first reported on it.
Number of Image Pages:
1 (67,070 Bytes)
1974-07-03 (July 3, 1974)
Ikonen, R. S.
Central Hospital of Tampere
Original Repository: Mount Holyoke College. Archives and Special Collections. Virginia Apgar Papers [MS 0504]
Reproduced with permission of Peter A. Apgar.
Medical Subject Headings (MeSH):
Second Career: The National Foundation-March of Dimes, 1959-1974
Never before has a doctoral thesis been written about the newborn scoring system which I reported in 1952! I do hope it helped
you attain your degree, and not the opposite.
It interests me to read how often the scoring system is expected to forecast conditions for which it was never intended.
As stated in 1953, the system was devised, as described on page 260 of your reference #7, "as a basis for discussion and
comparison of the results of obstetric practices, types of materna1 pain relief and the effects of resuscitation." Actually,
its uses were: 1) to predict infant mortality and 2) to point out to the physician the need for active resuscitation if the
total score vas four or less.
Now, 22 years later, the score is being examined for association with I.Q. at school age, behavioral disorders, fatal infant
diseases such as Tay-Sachs, autism, and length of time in the intensive care unit! I would not expect that there would be
either a positive or negative association with these parameters. However, it does no harm at all to investigate under what
conditions the score is useful or useless.
Dr. Erich Saling of West Berlin, who has quantitated the degree of asphyxia and acid-base balance, and I are attempting to
combine our methods and hope to have something published soon.
Thank you for the autographed thesis. Please give my best regards to Dr. Ahvenainen. I had hoped to visit you during the
Helsinki meeting of the European Teratology Society, but had to go to California instead.