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The Apgar Score helped decrease the infant mortality rate

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Re: The Apgar Score helped decrease the infant mortality rate

#51

Post by bobthepanda »

gumby wrote: post #44
throwaway1239Mx wrote: post #21

https://www.newyorker.com/magazine/2006/10/09/the-score This is linked in OP, but gives very slightly more detail around how the score was actually popularized, and what Apgar's career looked like. (Plot twist, she wasn't "just" a practicing anesthesiologist, but the founder and head of a whole new Anesthesiology dept. at Columbia) I think the short version is that she published a paper in 1953, and managed to get ob…

> She also carried around a scalpel and tubing for giving passers-by emergency airways (tracheotomy?), and apparently did so over a dozen times. My mother does the same (well did, she's retired. She was an ER doctor). Before seatbelts and other safety devices were common there were a lot of gruesome accidents on the roads and we would have to stop. I remember several episodes were my sister and I were bored and annoy…

The world is safer, kind of, but we also now heavily discourage activities deemed to be unsafe, and may have erred too far in that direction.

In the US, walking and biking to school has declined from nearly half in 1969 to 13% today. A Vancouver BC man recently won a lawsuit after he was taken through the child protective services wringer for letting his kids ride the bus unsupervised. While overall traffic deaths are down, the fatality rate for pedestrians is shooting up.

We have basically created a world where only car travel is safe, and where we explicitly and implicitly encourage driving and discourage walking to get anywhere.

Re: The Apgar Score helped decrease the infant mortality rate

#52

Post by andrewem »

fogleman wrote: post #28

BigQuery has a sample table, natality, that has all recorded births in the US from 1969 to 2008. It includes apgar_1min and apgar_5min fields. https://cloud.google.com/bigquery/public-data (Fun fact: I was actually able to find myself in the table based on my birthday, my birth state, my parent's ages and their birth states.)

Thanks for mentioning that! I took your example and was able to find myself - there was only one record which matched the combination of birth day and state, parents’ ages, and mother’s birth state (which is different than mine). Add in birth weight if you know it, and I speculate you’re almost certain to be able to find yourself.

An interesting aggregation query would be how much information is needed to uniquely identify some large percentage of all births in the data set.

Re: The Apgar Score helped decrease the infant mortality rate

#53

Post by lsllc »

ultimoo wrote: post #38

> "blue all over" = 0 > "blue at the extremities, body pink" = 1 > "no cyanosis" = 2 I wonder if they have updated guidance and training for scoring non-white babies. Brown and black babies probably don't turn blue in the same way white babies turn blue. In fact, a brown baby that's off color may appear to be a "healthy looking" - to the untrained eye - pink when in fact they should appear brown when healthy. I'd be…

Related: I don't know if you saw that there was a WAPO article posted 11 days ago to HN that covered that "mortality for black babies plummets when they are delivered by black doctors":

https://news.ycombinator.com/item?id=25716481

Re: The Apgar Score helped decrease the infant mortality rate

#54

Post by lqet »

cjohnson318 wrote: post #43
bwood wrote: post #12

> The newborn’s skin was blue and he wasn’t breathing. A few years earlier, the doctors would have documented the baby as stillborn, not believing there was anything they could do to help. As someone who scored a 1/10 on the Apgar at birth, I'd like to thank Dr. Apgar for saving my life.

My mom was born at an Air Force base in the 1950s. She said she was born silent and unresponsive, and they put her in another room to die, but then she recovered several hours later. That story always struck me as very odd, and heat breaking, but now it makes sense.

Two close family members (twins) were born in the late 1950s. An emergency baptism was immediately administered, their mother was told "there is nothing we can do" and the twins were given to her. They both survived.

Re: The Apgar Score helped decrease the infant mortality rate

#55

Post by michael1999 »

brazzy wrote: post #48
michael1999 wrote: post #46

And worsened maternal heath while deskilling obstetrics. https://www.newyorker.com/magazine/2006/10/09/the-score Blind Taylorism is dangerous. What we measure gets managed at the expense of unmeasured things.

You may want to read that article more attentively, because it does not support your claim at all .

Do I misread the concluding paragraphs?

"The skill required to bring a child in trouble safely through a vaginal delivery, however unevenly distributed, has been nurtured over centuries. In the medical mainstream, it will soon be lost."

"In a sense, there is a tyranny to the score. Against the score for a newborn child, the mother’s pain and blood loss and length of recovery seem to count for little. We have no score for how the mother does, beyond asking whether she lived or not—no measure to prod us to improve results for her, too. Yet this imbalance, at least, can surely be righted."

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