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Apgar Score

Apgar Score


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What is an Apgar Score?
How will a low Apgar Score affect my Baby?
Is there anything I should do as my child grows following a low Apgar Score?


What is an Apgar Score?

The Apgar score is a standardised way of checking the health of a newborn baby. It was named after its creator, Dr Virginia Apgar, Professor of Anesthesiology at Columbia University in the USA, who died in 1974.

Until the publication of Apgar’s Newborn Scoring System in 1953, many internal problems at birth, such as circulatory or breathing difficulties, were missed by doctors because it was usually assumed that a newborn baby was healthy unless there was an obvious sign of something being wrong.

The Apgar score was designed to assess a baby’s health quickly: the checks are conducted at one minute and 5 minutes after birth. The score is based on 5 elements, which are sometimes named after the letters in Apgar’s name:

The Apgar newborn scoring system

Appearance which relates to the pinkness or blueness of the baby’s skin tone
Blue or pale skin tone = 0.
Pink body but blue fingers and toes = 1.
Completely pink = 2.

Pulse which relates to its heart rate
No heart rate detected = 0.
Slow heart rate (below 100 beats per minute) = 1.
Fast heart rate (more than 100 beats per minute) = 2.

Grimace which tests the baby’s reflexes and response when the sole of its foot is stimulated
No response when the sole of the foot is stimulated = 0.
Baby grimaces when the foot is stimulated = 1.
Baby cries when the foot is stimulated = 2.

Activity which checks the baby’s muscle tone
Baby is limp = 0.
Baby shows some muscle flexing in its feet and hands = 1.
Baby is active and can flex the muscles in its feet and hands = 2.

Respiration which assesses the rate of the baby’s breathing
There are no signs of the baby’s breathing = 0.
Baby has only a weak cry and can’t seem to get enough air into its lungs = 1.
Baby is breathing well and can cry strongly = 2.

A score of 7 out of 10, or more is considered normal. However, if the baby has a low score at one minute and a normal score at 5 minutes, this, too, is considered normal, particularly if the birth took a long time, or if the mother was given pethidine during labour, which can affect the baby’s breathing.

How will a low Apgar Score affect my Baby?

A low Apgar score gives doctors a warning signal that they should check the baby for hidden health problems, such as breathing difficulties or internal bleeding, and allows them to give the baby crucial medical attention when it is most needed.

Is there anything I should do as my child grows following a low Apgar Score?

  • more to come
myDr, 2002

Reviewed : 18/7/2006

Health Dimensions ©2004