Newborn scoring; Delivery - Apgar
Apgar is a quick test performed on a baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the health care provider how well the baby is doing outside the mother's womb.
In rare cases, the test will be done 10 minutes after birth.
Virginia Apgar, MD (1909-1974) introduced the Apgar score in 1952.
The Apgar test is done by a doctor, midwife, or nurse. The provider examines the baby's:
Each category is scored with 0, 1, or 2, depending on the observed condition.
Heart rate is evaluated by stethoscope. This is the most important assessment:
Grimace response or reflex irritability is a term describing response to stimulation, such as a mild pinch:
This test is done to determine whether a newborn needs help breathing or is having heart trouble.
The Apgar score is based on a total score of 1 to 10. The higher the score, the better the baby is doing after birth.
A score of 7, 8, or 9 is normal and is a sign that the newborn is in good health. A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for after birth.
Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs to adjust outside the mother's womb.
Most of the time a low Apgar score is caused by:
A baby with a low Apgar score may need:
Most of the time, a low score at 1 minute is near-normal by 5 minutes.
A lower Apgar score does not mean a child will have serious or long-term health problems. The Apgar score is not designed to predict the future health of the child.
Arulkumaran S. Fetal surveillance in labor. In: Arulkumaran SS, Robson MS, eds. Munro Kerr's Operative Obstetrics. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 9.
Goyal NK. The newborn infant. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 113.BACK TO TOP
Review Date: 10/2/2020
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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