Apgar score

The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two and summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10.

The five criteria of the Apgar score

	Score 0	Score 1	Score 2
Heart rate	absent	<100	>100
Respiration	absent	weak or irregular	strong
Muscle tone	none	some flexion	active movement
Reflex irritability	no response to stimulation	grimace/feeble cry when stimulated	sneeze/cough/pulls away when stimulated
Skin color	blue all over	blue at extremities	normal

The test is generally done at 1 and 5 minutes after birth, and may be repeated later if the score is, and remains, low. Scores below 3 are generally regarded as critically low, with 4 – 7 fairly low and over 7 generally normal.

Low scores at the one minute test may require medical attention, but are not a an indication of longer term problems, particularly if there is an improvement by the stage of the five minute test. Certainly if the Apgar score remains below 3 for the longer periods 10 minutes, 15 mins, 30 mins etc., there is a risk that the child will suffer longer term neurological damage. There is also a small but significant increase in the risk of cerebral palsy. However, the purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care; it was not designed to make long–term predictions on a child's health.

Some ten years after the initial publication, the acronym APGAR was coined in the US as a mnemonic learning aid: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration.

Literature

• Apgar, V.: A proposal for a new method of evaluation of the newborn infant, Curr. Res. Anesth. Analg. 1953;32, pp. 260–267

See also

• Glasgow Coma Score

Referenced By