The Apgar score is a set of criteria used to evaluate the physical condition of a baby immediately after delivery. This system was first devised in 1952 by Dr. Virginia Apgar as a means of quickly summarizing an infant’s health. Dr. Apgar’s goal was to creat a system that would be simple to use and easily repeated. The Apgar score can be used to determine if a newborn needs emergency care or further medical assistance.
Criteria
Five factors can be added up to equal a newborn’s total Apgar score, including:
- Appearance, such as muscle tone or skin coloration
- Pulse
- Grimace response or reflex irritability
- Activity
- Respiration
This test is typically conducted between one and five minutes after the baby is born and may be repeated if the initial score is considered low. A score of zero to three is regarded as critically low, four to six is moderately low, and seven to ten is considered normal functioning. A score of ten is very rarely achieved but does not differ greatly from a score of nine.
Low Apgar Score Indications
A lower score may indicate that the infant requires medical attention but does not necessarily guarantee the baby will have long-term health issues, as the score may rise during the five-minute test. However, an Apgar score that remains below three during additional testing such as 15 or 30-minute markers is a strong indication that possible long-term neurological damage is present, as well as an increase in the risk of cerebral palsy.
It should be noted that the Apgar test was designed as a means of articulating a child’s immediate medical needs and was not intended to make long-term predictions regarding the baby’s health. External factors such as physiological maturity, medications taken by the mother, and the presence of congenital malformations can influence a baby’s Apgar score.
Neonatal Death Rates
American neonatal death rates associated with five-minute Apgar scores were:
- 0 to 3: 244 per 1,000 in term babies and 315 per 1,000 in preterm babies
- 4 to 6: 9 per 1,000 in term babies and 72 per 1,000 in preterm babies
- 7 to 10: 0.2 per 1,000 in term babies and 5 per 1,000 in preterm babies
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