en Pediatrics Pediatrics پژوهشي Research <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Introduction</b>: The Apgar score, assessing newborns&#39; health at birth, indicates adverse conditions and the need for medical attention. This study investigates its predictive value for neonatal outcomes.</span></span><br> <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Material & Methods</b><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: </span></span></b>This retrospective cohort study involved 207 neonates in Ilam city hospitals (2015-2016). It compared two groups: 69 neonates with Apgar scores <7 (exposed) and 138 with scores &ge;7 (unexposed) at birth. Neonates were followed through the neonatal period, and outcomes were compared. Statistical analysis used SPSS Statistics software.</span></span><br> <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Results</b><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: </span></span></b>At the fifth minute, the exposed group had higher rates of resuscitation need (51% vs. 26.7%, p=0.01), re-admission (51% vs. 31.1%), and mortality (60% vs. 12.2%, p=0.03) compared to the unexposed group. Relative risks for the exposed group were 3.8 (resuscitation), 6.1 (NICU admission), 2.94 (re-admission), and 2.5 (mortality) at the first minute, and 2.9, 2.7, 2.3, and 19.9, respectively, at the fifth minute.</span></span><br> <span style="font-size:9pt"><span minion="" pro="" style="font-family:"><b>Conclusion</b><b><span style="font-size:11.0pt"><span new="" roman="" style="font-family:" times="">: &nbsp;</span></span></b>Apgar scores <7 increase the risk of adverse neonatal outcomes including NICU admission, resuscitation, and higher mortality rates. The Apgar score serves as a valuable predictor of adverse neonatal outcomes.</span></span> Apgar Score, Neonatal Complications, Cohort Study 22 32 http://jbrms.medilam.ac.ir/browse.php?a_code=A-10-41-5&slc_lang=en&sid=1 Khairollah Asadollahi masoud_1241@yahoo.co.uk 10031947532846006771 10031947532846006771 Yes Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Arezoo Karimi 10031947532846006772 10031947532846006772 No Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran Nazanin Rezaei 10031947532846006773 10031947532846006773 No Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran MirHadi Mussavi 10031947532846006774 10031947532846006774 No Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Monireh Azizi 10031947532846006775 10031947532846006775 No Associate professor, Department of Anatomy, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Salman Daliri 10031947532846006776 10031947532846006776 No Health Deputy, Shiraz University of Medical Sciences, Shiraz, Iran