Apgar Score

figure 1

Apgar Scores Fig. 1

The Apgar score is a test used to measure the vital signs of a baby at birth (fig. 1).

Virginia Apgar, M.D. (1909-1974) introduced the Apgar score in 1952. This test is a screening tool for health care providers to determine what assistance is immediately necessary to help a newborn stabilize.

The Apgar score is now used worldwide to quickly assess the health of an infant one minute and five minutes after birth. The 1-minute Apgar score measures how well the newborn tolerated the birthing process. The 5-minute Apgar score assesses how well the newborn is adapting to the environment.

What Will Happen?

At one and five minutes after your baby is born, the attending health care provider will assess five vital areas of newborn health. The Apgar score uses measures of 0, 1, or 2 for each category, with the best possible total score equaling 10.

  1. Heart Rate:

    a. Absent heartbeat = 0.
    b. Slow heartbeat (less than 100 beats per minute) = 1.
    c. Adequate heartbeat (more than 100 beats per minute) = 2.


  2. Respiration:

    a. Not breathing = 0.
    b. Weak cry, irregular breathing = 1.
    c. Strong cry = 2.


  3. Muscle Tone:

    a. Limp, flaccid = 0.
    b. Some flexing or bending = 1.
    c. Active motion = 2.


  4. Response to Stimulation (also called Reflex Irritability):

    a. No response = 0.
    b. Grimace = 1.
    c. Vigorous cry or withdrawal = 2.


  5. Color:

    a. Pale or blue = 0.
    b. Normal color body but blue extremities = 1.
    c. Normal color = 2.

Results

A score of seven to 10 is normal and indicates your newborn is in good condition. A score of 10 is very unusual. Almost all newborns lose one point for blue hands and feet.

Any score less than seven indicates your baby needs assistance making the transition to life outside the womb. Health-care personnel should take appropriate action, for example, helping the infant breathe. The Apgar score may be repeated at 10 minutes and later to assess the effectiveness of the intervention or treatment.

Frequently Asked Questions

Q: Does the Apgar score predict the future health of my baby?

A: In general the Apgar score alone does not predict the future health of the baby. A very low 5-minute Apgar score has been associated with a slight increased risk for cerebral palsy in full-term infants, but the vast majority of infants with low 5-minute Apgar scores do not develop CP.

Q: Does my child's Apgar score predict how smart he will be?

A: Apgar scores assess the health and well-being of an infant at birth. They do not predict a child's ability to perform well academically.

Q: I've seen APGAR written in all-caps. Isn't it an acronym?

A: The Apgar score was originally named after its creator, Virginia Apgar, M.D. After the Apgar score became standard, the categories were renamed to form the acronym APGAR:

  • Appearance (Color)
  • Pulse (Heart Rate)
  • Grimace (Response to Stimulation)
  • Activity (Muscle Tone)
  • Respiration (Respiration)

Review Date: 1/2/2007
Reviewed By: Douglas A. Levine, MD, Gynecology Service, Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M.'s health encyclopedia is accredited by URAC, also known as the American Accreditation Healthcare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial reviewers. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

A.D.A.M.
 

Existing Members


 
Forgot Password?

Featured Partner

Blessings

Blessings of Birth Doula & Childbirth Services—“Where Moms are Pampered.” Tina Black, Certified Doula & Childbirth Educator. Offering childbirth classes, birth doula services, breastfeeding assistance and more. (Kelso | 360-431-8275) 
 
Did you/will you get the flu shot while pregnant?

 

View Polls Archive

Local Angle

 

Howe family photo

Encouragement + An Assist = Success

Nine days past her due date, Sara Howe was awakened at 3:00AM when her water broke. Thrilled that the long wait was finally over, Sara and her husband David packed up and headed to PeaceHealth Southwest Medical Center. By 5:00AM they were comfortably settled into one of PeaceHealth Southwest’s Labor Delivery Recovery and Postpartum rooms, ready for action. But four hours later, Sara contractions had still not progressed so her midwife started her on Pitocin. Soon the contractions kicked in and Sara was well on her way.

At around eight o’clock the next morning, it was time for Sara to start pushing. So she pushed. And she pushed, and she pushed, and she pushed. "The first few hours of pushing went by without me realizing the time," remarked Sara. "But around the fourth hour I started to wonder if I was still making progress. That is when the encouragement of my midwife, husband and the PeaceHealth Southwest nursing staff kept me going. It was like I had my own cheering section."

Unfortunately, even with all the support and encouragement, Sara’s labor was not progressing because her baby’s head was tilted in the birth canal. Neither Sara or her midwife wanted her to have a Cesarean section after all that work, so her midwife suggested an assisted delivery. Read more >

Share your story. Submit your story with a local angle, and you could receive a free gift if it is selected for publication.