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.
Five factors can be added up to equal a newborn’s total Apgar score, including:
- Appearance, such as muscle tone or skin coloration
- Grimace response or reflex irritability
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