SUPPLEMENTARY RESOURCE MATERIAL
Neonatal Assessment through APGAR SCORE
The Apgar score is a test given to newborns soon after birth. This test checks a
baby's heart rate, muscle tone, and other signs to see if extra medical care or
emergency care is needed.
The test is usually given twice: once at 1 minute after birth, and again at 5
minutes after birth. Sometimes, if there are concerns about the baby's condition, the test
may be given again.
What Does "Apgar" Mean?
Apgar stands for "Appearance, Pulse, Grimace, Activity, and Respiration."
In the test, five things are used to check a baby's health. Each is scored on a scale of 0
to 2, with 2 being the best score:
1.
2.
3.
4.
5.
Appearance (skin color)
Pulse (heart rate)
Grimace response (reflexes)
Activity (muscle tone)
Respiration (breathing rate and effort)
Add up these five factors for the Apgar score. Scores are between 10 and 0. Ten is the
highest score possible, but few babies get it. That's because most babies' hands and
feet remain blue until they have warmed up.
Apgar Scoring
Apgar Sign
2
Pulse
(heart rate)
0
Normal
Normal
Bluish-gray
color all
color (but
or pale all
hands and
over
over (hands
Appearance and feet are
(skin color)
1
feet are
pink)
bluish)
Normal
Below 100
Absent
(above 100
beats per
(no pulse)
minute
beats per
minute)
Grimace
("reflex
Pulls away,
Facial
Absent (no
sneezes,
movement
response to
coughs, or
only
stimulation)
cries with
(grimace)
stimulation
with
stimulation
irritability")
Active,
Arms and
No
spontaneous
legs flexed
movement,
movement
with little
"floppy"
tone)
movement
tone
Respiration Normal rate
and effort,
(breathing
Slow or
Absent (no
irregular
breathing)
Activity
(muscle
rate and
good cry
effort)
breathing,
weak cry
What Does My Baby's Score Mean?
A baby who scores a 7 or above on the test is considered in good health. A lower score
does not mean that your baby is unhealthy. It means that your baby may need some
immediate medical care, such as suctioning of the airways or oxygen to help him or her
breathe better. Perfectly healthy babies sometimes have a lower-than-usual score,
especially in the first few minutes after birth.
A slightly low score (especially at 1 minute) is common, especially in babies born:




after a high-risk pregnancy
through a C-section
after a complicated labor and delivery
prematurely
At 5 minutes after birth, the test is given again. If a baby's score was low at first and
hasn't improved, or there are other concerns, the doctors and nurses will continue any
necessary medical care. The baby will be monitored closely.
What if My Baby Has a Low Score?
Many babies with low scores are perfectly healthy and do just fine after adjusting to life
outside the womb.
If your doctor or midwife is concerned about your baby's score, he or she will let you
know and will explain how your baby is doing, what might be causing problems (if any),
and what care is being given.
What Else Do I Need to Know?
This test was not designed to predict a baby's long-term health, behavior, intelligence,
personality, or outcome. It was designed to help health care providers tell a newborn's
overall physical condition so that they could quickly decide whether the baby needed
immediate medical care.
With time to adjust to the new environment and with any necessary medical care, most
babies do very well. So rather than focusing on a number, just enjoy your new baby!
Reference
https://kidshealth.org/en/parents/apgar.html