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About the Apgar Score

The Apgar score, the very first test given to your newborn, occurs in the delivery or birthing room right after your baby's birth. The test was designed to quickly evaluate a newborn's physical condition and to determine any immediate need for extra medical or emergency care.

Although the Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar, you may have also heard it referred to as an acronym for: Appearance, Pulse, Grimace, Activity, and Respiration.

The Apgar test is usually given to a baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Sometimes, if there are concerns about the baby's condition or the score at 5 minutes is low, the test may be scored for a third time at 10 minutes after birth.

Five factors are used to evaluate the baby's condition and each factor is scored on a scale of 0 to 2, with 2 being the best score:

1. appearance (skin coloration) 2. pulse (heart rate) 3. grimace response (medically known as "reflex irritability") 4. activity and muscle tone 5. respiration (breathing rate and effort) Doctors, midwives, or nurses add these five factors together to calculate the Apgar score. Scores obtainable are between 10 and 0, with 10 being the highest possible score.

Apgar Scoring Apgar Sign Heart Rate (pulse) 2 Normal (above 100 beats per minute) Breathing (rate and effort) Normal rate and effort, good cry Slow or irregular breathing, Absent (no breathing) 1 Below 100 beats per minute 0 Absent (no pulse)

weak cry Grimace (responsiveness or "reflex irritability") Pulls away, sneezes, coughs, or cries with stimulation Facial movement only (grimace) with stimulation Activity (muscle tone) Active, spontaneous movement Arms and legs flexed with little movement Appearance (skin coloration) Normal color all over (hands and feet are pink) Normal color (but hands and feet are bluish) No movement, "floppy" tone Bluish-gray or pale all over Absent (no response to stimulation)

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