Just after a baby is born, a doctor, midwife or nurse performs a quick test on the newborn and gives he or she an Apgar score. The test is typically completed one minute after birth and again five minutes later. The goal is to evaluate the baby’s health and determine if he or she requires any immediate or extra medical care. The scoring ranges from 1 to 10, with 10 being the best.
Virginia Apgar, an obstetrical anesthesiologist and professor at Columbia University, created the Apgar score in 1952. She was interested in studying the effects of anesthesia given to laboring mothers on their newborn babies. As part of her research, she developed the Apgar score.
Although the score was named after its creator, APGAR is also an acronym for the different areas evaluated that make up the score: Appearance, Pulse, Grimace, Activity and Respiration. Each area receives a score of 0, 1 or 2, and all categories are totaled for a final score.
- Appearance: The newborn’s skin color is the main focus of his or her appearance. If the baby’s skin is blue or pale all over, the baby scores a 0. If the baby’s feet are blue, but the rest of the body is pink, he or she scores a 1. If the baby’s skin is pink all over, including the feet, the baby scores a 2. Most babies have blue feet just after birth, so it’s rare that a baby receives a 2 for appearance.
- Pulse: This category is based on the baby’s heart rate. If there is no heartbeat, the newborn scores a 0. If the heart rate is below 100 beats per minute, the baby scores a 1. If the heart rate is above 100 beats per minute (normal range), he or she receives a 2.
- Grimace: Grimace is determined by something called “reflex irritability” which is the baby’s response to stimulation such as a tickle or a pinch. If the baby does not respond to stimulation, he or she scores a 0. If the baby grimaces (makes a face but does not move), a score of 1 is given. If the baby cries, tries to pull away or sneezes, he or she scores a 2.
- Activity: For scoring activity, doctors look at a baby’s muscle tone. If no muscle tone or movement is found, the newborn gets a 0. If there is some tone and movement, the baby scores a 1. If active and spontaneous movement is present, the baby scores a 2.
- Respiration: The respiration score is determined by breathing effort. If the newborn is not breathing at all, he or she scores a 0. If the breathing is slow and labored and crying is weak, the baby scores a 1. If breathing is normal and the baby cry is strong, he or she scores a 2.
Newborns rarely receive a perfect 10. A score of 7, 8 or 9 signifies that the baby is doing well and does not require any immediate emergency care.
If you have any questions regarding the Apgar newborn screening or other pregnancy concerns, browse our knowledge center or make an appointment to talk with an experienced Gainesville area OB/GYN at All About Women today.