Selective nonreporting of 5-min Apgar scores and its safety assessment of out-of-hospital births: a population-based study of United States’ birth data, 2016–2023.
Advocacy that relies on incomplete reporting is not evidence-based care.
The Lancet Regional Health – Americas published in February 2026 an article entitled: “Selective nonreporting of 5-min Apgar scores and its safety assessment of out-of-hospital births: a population-based study of United States’ birth data, 2016–2023.”
This population-based observational study analyzed U.S. birth certificate data from 2016 to 2023, focusing on term, normal-birthweight, midwife-attended births. The authors compared how often 5-minute Apgar scores were missing across hospital births, freestanding birth centers, and planned home births. Missing Apgar scores were far more common in out-of-hospital settings, especially home births. Sensitivity analyses tested how different assumptions about missing scores changed estimates of neonatal risk.
