Apgar test
Measured at one and five minutes after birth the Score values are totalled for all indicators: 7-10 is considered normal, 4-7 may require resuscitative measures, 3 and below require immediate resuscitation.
In recent years there has been some controversy of the relevance and accuracy of some of the criteria used in this test, though many feel it is still an invaluable initial assessment tool.
Indicator | Score 0 | Score 1 | Score 2 |
Activity (muscle tone) | Limp; no movement | Some flexion of arms and legs | Active motion |
Pulse (heart rate) | No heart rate | Fewer than 100 beats per minute | At least 100 beats per minute |
Grimace (reflex response) | No response to airways being suctioned | Grimace during suctioning | Grimace and pull away, cough, or sneeze during suctioning |
Appearance (color) | The baby's whole body is completely bluish-gray or pale | Good color in body with bluish hands or feet | Good color all over |
Respiration (breathing) | Not breathing | Weak cry; may sound like whimpering, slow or irregular breathing | Good, strong cry; normal rate and effort of breathing |
Recent Apgar Studies
Recently two large neonatal studies have examined whether the Apgar score is still a relevant neonatal assessment tool.
Thorngren-Jerneck K, Herbst A. Low 5-minute Apgar score: a population-based register study of 1 million term births. Obstet Gynecol. 2001 Jul;98(1):65-70.
Casey BM, McIntire DD, Leveno KJ The continuing value of the Apgar score for the assessment of newborn infants. N Engl J Med. 2001 Feb 15;344(7):467-71.