APGAR Score

The APGAR score is a number given to a baby at 1 and 5 minutes after birth. The 1 minute score tells how well the baby survived the birth process. The 5 minute score tells how the baby is adapting to being outside of the womb. It is a standard way to exam babies before they leave the delivery room. The test is scored on 10 points. The highest score is 10. The lowest is 0.

Both the tests are the same. They are the total of points from five observations:

ACTIVITY

  • 2 points if the baby is active, moving arms and legs.

  • 1 point if the baby's arms are curled up and legs are bent.

  • 0 points if the baby is limp.

PULSE (HOW MANY TIMES THE HEART BEATS IN A MINUTE)

  • 2 points if the pulse is over 100. A baby's heart is tiny, so it beats fast.

  • 1 point if the pulse is 80-100.

  • 0 points if the pulse is absent or below 80.

GRIMACE

  • 2 points if the baby coughs or pulls away when suctioned.

  • 1 point if the baby makes a face when suctioned or touched.

  • 0 points if the baby does not respond at all.

APPEARANCE

  • 2 points if the skin is the same color all over the body.

  • 1 point if the arms and legs are a different, usually bluish color.

  • 0 points if the baby is pale or bluish gray.

RESPIRATION OR BREATHING

  • 2 points if the baby is crying.

  • 1 point if breathing is slow or weak. This can happen if the mother has had narcotics.

  • 0 points if the baby is not breathing at all.

Scores below 3 are critically low, scores 4 to 6 are fairly low and scores 7 to 10 are normal. A low score in the first minute indicates that the baby needs some type of assistance. If the score remains low longer than 10 minutes there is a risk of the baby having neurological problems.

Even babies with lower scores at ten minutes tend to do well. The score does not predict intelligence, personality, or abilities.

The APGAR Score is not used in newborn babies that require immediate resuscitation. The ABC, airway, breathing and circulation emergency evaluation is used.