Neonatal pneumothorax in association with APGAR score: A systematic review and meta-analysis

Introduction: Pneumothorax (PTX) is a potentially fatal condition that primarily affects neonates. Premature babies are more likely to have underlying lung diseases, such as respiratory distress syndrome (RDS), which increases the risk of air leakage. Methodology: This was a systematic review and meta-analysis to estimate the association between neonatal PTX and Apgar score. A systematic electronic search was implemented through Google Scholar, PubMed, Web of Science, Science Direct, and EBSCO to include the eligible studies. Results: A total of 5 studies were included, with 357 patients (135 cases and 222 controls). The estimated association between the 5-minutes APGAR score and Neonatal PTX was [SMD=-0.91, (95% CI; -1.49, -0.33), P=0.002] and [SMD=-0.71,(95% CI; -1.01, -0.40), P=0.000] with the 1-minute APGAR score. Conclusion: We demonstrated a significant association between 1-minute and 5-minutes APGAR scores and neonatal PTX. The highest risk was found among neonates admitted to the ICU and those with persistent PTX.