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Abstract First developed in 1952 by Virginia Apgar, the Apgar scoring system was designed to assess the likelihood of a newborn’s survival through clinical evaluation to decide whether or not to commence any rapid resuscitative interventions. Factors such as infection, congenital anomalies, and preterm birth significantly altered the scoring process. This, along with the relative subjectivity employed in gathering the information about a newborn’s physiological status, has raised some concerns regarding the reliability of the Apgar scoring system. Subsequent attempts at improving the Conventional Apgar scoring system have led to developing a few modified versions of the scoring process (i.e., the Specified-Apgar, Expanded Apgar, and Combined Apgar scores). The Combined Apgar score specifically incorporates both the Specified and Expanded versions of the score to allow for a more comprehensive analysis of a newborn’s postnatal clinical status. Newly proposed NRAS score were studied by three studies only in literarture. We conducted this observational study to assess the value of the Neonatal Resuscitation and Adaptation Score (NRAS) compared to the Conventional Apgar and Combined Apgar score in predicting neonatal mortality and morbidity. We performed this prospective cohort study between April 2019 to June 2020. Ninety three neonates were admitted to the Menoufia University Hospitals. We extracted the clinical and demographic data, including mode of delivery, type of gender, birth weight, maternal risk factors, and causes of NICU admission. We measured Conventional Apgar, Combined Apgar, and NRAS scores for the neonates at 1 and 5 minutes after delivery at the delivery room. All neonates were followed for up to detect any adverse outcomes, either mortality or short-term morbidities by clinical examination and investigations. The neonates’ percentages of 1-min and 5-min NRAS scores regarding morbidity and mortality were significantly higher than those of Conventional Apgar and Combined Apgar. |