The Apgar score is a medically accepted assessment of a newborns health. Find out more on how the Apgar score is calculated and interpreted.
Last Updated: Oct 22, 2020 11:29 GMT
The first few minutes of a newborn life are critical. Closely monitoring the baby soon after birth is important to help act fast on medical interventions, if needed any, in order to save the baby from serious complications.The Apgar Score
- If the baby shows no signs of breathing, the score is 0.
- If the baby is breathing but breathes are slow, irregular, weak or gasping, the score is 1.
- If the baby is crying vigorously, it indicates normal breathing and the score is 2.
- If there is no heartbeat, the score is 0.
- If the heart rate is less than 100 beats per minute, the score is 1.
- If the heart rate is more than 100 beats per minute, the score is 2.
- If the infant shows no movement, the score is 0.
- If the infant shows some flexion, the score is 1.
- If the infant is showing an active movement of limbs with good muscle flexion, the score is 2.
- If there is no response to stimulation, the score is 0.
- If baby makes an expression of grimace in response to stimulation, the score is 1.
- If baby cries, sneezes or coughs when stimulated, the score is 2.
- If the baby’s body is pale or blue in color, the score is 0.
- If the baby’s body is pink and extremities are blue, the score is 1.
- If the baby’s body is completely pink, the score is 2.
- The first score taken at 1 minute is usually not 10 because babies do not exhibit pink body color within 1 minute of coming out.
- The 1-minute score of 7 – 10 is normal.
- The 1-minute score of 4 – 6 indicates that the baby requires external assistance for breathing like oxygen supply or suctioning of nostrils.
- The 1-minute score of 3 or less is a sure sign of emergency resuscitation.
- A low 1-minute score is necessarily not an indication of long-term health risks as long as the 5-minutes score is normal.
- A low 5-minutes score may be predictive of increased risk for mortality or cerebral palsy.
- When the 5-minutes score is less than 7, recording of the scores is continued for an additional 5 minutes. If the 10-minutes score is less than 5, the risks for neurological complications is higher.
- Preterm babies may not score well, especially in the 1-minute recording, because of inadequate growth and maturity.
- Babies with congenital abnormalities may show altered Apgar scores.
- Apgar scores may also be affected by factors such as cesarean delivery, low birth weight, maternal anesthesia, or complications during delivery.
- Apgar scores may carry a slight degree of variability from person to person. If a doctor or nurse was to record the 1-minute score of muscle tone or reflexes, and if another doctor and nurse were to record the 5-minutes score of muscle tone, each may show some variability in their observation. Hence, the Apgar score is considered subjective by some.