Devised by Dr. Virginia Apgar in 1952, the Apgar score is a number from 1-10 that indicates how healthy a newborn is at birth, based on five categories; Appearance, Pulse rate, Grimace (reflex), Activity, and Respiratory effort. A score of 7 or above is considered normal, while 4 to 6 is low, and 3 or below is critically low. The test is most frequently done at one and five minutes after birth, but may be performed again if the score is below 7 at the one or five minute intervals. A low score may mean that the baby requires medical attention, but does not necessarily indicate long-term problems.
Each of the five categories of the Apgar test is graded from 0-2, with 0 the lowest and 2 the highest. The scores from each of the five categories are added together to come up with the overall Apgar score.
“A”ppearance
The “Appearance” portion measures oxygen flow across the body – a baby who is not getting enough may have a blue tint. A score of ‘0’ will be given to those who are blue in the body and extremities, while a ‘1’ will be given to those who are blue just in the extremities. Babies whose bodies and extremities are totally pink and healthy will be given a ‘2’.
“P”ulse rate
The “Pulse” section measures the heart rate to make sure that a newborn’s heart is functioning as it should. Babies with absent pulse rates get a score of ‘0’, while those whose pulse rates exist but are below 100 are given a ‘1’, and those with a pulse of over 100 get a ‘2’.
“G”rimace (reflex)
This measures the baby’s reflexes – how they respond to stimulation. A baby geting a ‘0’ will not respond to stimulation. A baby who gets a ‘1’ will make some slight reaction, and a baby getting a ‘2’ will cry or pull away when stimulated.
“A”ctivity
The “Activity” portion scores baby on how well they are moving around. A baby who displays little activity will get a ‘0’. A baby with a ‘1’ will show some flexion, while a baby who gets a ‘2’ will display flexed arms and legs, and resist extension.
“R”espiratory effort
This section measures the amount of effort a baby is able to put toward breathing. A baby who displays no signs of breathing will get a ‘0’. Weak or inconsistent gasping gets a ‘1’, and a strong cry will get a ‘2’.
What happens if the score is low?
Oftentimes, a baby with a total score below ‘7’ may be in need of some extra medical attention, but this is not always the case – your healthcare provider will be able to give you a clear assessment of your baby’s health regardless of the Apgar score. The Apgar score is among the best-known neonatal tests in the United States, but it is not universal. Your healthcare provider may have a different rubric that they use to score Baby‘s health, even if you are in the US.
Reviewed by Dr. Jamie Lo
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Sources
- “Apgar score.” U.S National Library of Medicine. MedlinePlus, 11/20/2014. Web.
