The Apgar score is a numerical score developed by Virginia Apgar, MD, an American anesthesiologist, in 1952 to standardize the description of newborn infant medical stability in the delivery room. A scale from 0 (worst) to 2 (normal) is assigned to the following parameters: heart rate (no heart rate to normal >100 beats per minute), respiratory effort (no respiratory effort to cries and has regular breathing), muscle tone (flaccid to active motion), reflex irritability (no response to grimace and cry), and skin color (dusky blue to pink). The scores are added up to quantify the infant's status at 1 and 5 min. Infants rarely receive perfect scores of 10 because they typically have bluish-colored fingertips even if they are otherwise pink (1 for color). Lower Apgar scores may reflect neonatal stress, use of maternal anesthetic, and immaturity or prematurity. Apgar scores were designed for use with term infants. Scores of 0–3 at 1 and 5 min indicate neonatal depression and suggest the need for medical attention to help the baby adjust to postnatal conditions. A lower Apgar score at 1 min with a normal range score at 5 min is not typically of concern. Apgar scores are not measures of neonatal asphyxia or necessarily predictive of later neurologic impairment.
References and Reading
- American Academy of Pediatrics, Committee on Fetus and Newborn and Committee on Obstetric Practice, American College of Obstetrics and Gynecology. (1996). Use and abuse of the Apgar score. Pediatrics, 98, 141–142.Google Scholar
- Health children, American Academy of Pediatrics. http://www.healthychildren.org/English/ages-stages/prenatal/delivery-beyond/pages/Apgar-Scores.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token. Accessed 23 May 2012.
- National Library of Medicine and National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003402.htm. Accessed 23 May 2012.