An evaluation of a newborn’s physical status by assigning numerical values (0-2) to each of 5 criteria:
- heart rate
- respiratory effort
- muscle tone
- response stimulation, and
- skin colour
(see table below). A score of 8-10 indicates the best possible condition (a score of 10, however, is very unusual as most newborns lose one point for blue hands and feet). A score of 5 or less is taken to mean that the newborn needs immediate assistance. It is usually carried out at 1 minute (to assess toleration to the process of birth) and again at 5 minutes (to assess the newborn’s adjustment to the postnatal environment) after birth. An Apgar score by itself reveals only the newborn’s condition immediately after birth, and is not intended to be predictive of later developmental outcomes. Devised by the obstetrician Virginia Apgar (1909-1974) and published in 1953.
Apgar scoring system
|
Item \ Score
|
0
|
1
|
2
|
|
Heart rate
|
Absent
|
Below 100 bpm
|
Over 100 bpm
|
|
Respiratory effort
|
Absent
|
Slow, irregular breathing |
Good, strong cry
|
|
Muscle tone
|
Limp
|
Some flexion of
extremities |
Active movement and legs |
|
Response to stimulation |
No response
|
Grimace
|
Cry, sneeze, cough, or pull away of foot |
|
Skin colour
|
Blue pale, pale all over |
Body pink, extremities blue |
Completely pink
|
bpm: beats per minute