Pediatric General
What Is the Apgar Score?The Apgar score is a test given to newborns soon after birth. This test checks a baby's heart rate, muscle tone, and other signs to see if extra medical care or emergency care is needed.
The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth. Sometimes, if there are concerns about the baby's condition, the test may be given again.
What Does "Apgar" Mean?Apgar stands for "Appearance, Pulse, Grimace, Activity, and Respiration."
In the test, five things are used to check a baby's health. Each is scored on a scale of 0 to 2, with 2 being the best score:
Apgar Scoring
Apgar Sign 2 1 0
Appearance
(skin color)Normal color all over (hands and feet are pink)Normal color (but hands and feet are bluish)Bluish-gray or pale all over
Pulse
(heart rate)Normal (above 100 beats per minute)Below 100 beats per minuteAbsent
(no pulse)
Grimace
("reflex irritability")Pulls away, sneezes, coughs, or cries with stimulationFacial movement only (grimace) with stimulationAbsent (no response to stimulation)
Activity
(muscle tone)Active, spontaneous movementArms and legs flexed with little movementNo movement, "floppy" tone
Respiration
(breathing rate and effort)Normal rate and effort, good crySlow or irregular breathing, weak cryAbsent (no breathing)What Does My Baby's Score Mean?A baby who scores a 7 or above on the test is considered in good health. A lower score does not mean that your baby is unhealthy. It means that your baby may need some immediate medical care, such as suctioning of the airways or oxygen to help him or her breathe better. Perfectly healthy babies sometimes have a lower-than-usual score, especially in the first few minutes after birth.
A slightly low score (especially at 1 minute) is common, especially in babies born:
What if My Baby Has a Low Score?Many babies with low scores are perfectly healthy and do just fine after adjusting to life outside the womb.
If your doctor or midwife is concerned about your baby's score, he or she will let you know and will explain how your baby is doing, what might be causing problems (if any), and what care is being given.
What Else Do I Need to Know?This test was not designed to predict a baby's long-term health, behavior, intelligence, personality, or outcome. It was designed to help health care providers tell a newborn's overall physical condition so that they could quickly decide whether the baby needed immediate medical care.
With time to adjust to the new environment and with any necessary medical care, most babies do very well. So rather than focusing on a number, just enjoy your new baby!
Reviewed by: Mary L. Gavin, MD
Date reviewed: February 2018Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2018 The Nemours Foundation. All rights reserved.
Images provided by The Nemours Foundation, iStock, Getty Images, Veer, Shutterstock, and Clipart.com.
The test is usually given twice: once at 1 minute after birth, and again at 5 minutes after birth. Sometimes, if there are concerns about the baby's condition, the test may be given again.
What Does "Apgar" Mean?Apgar stands for "Appearance, Pulse, Grimace, Activity, and Respiration."
In the test, five things are used to check a baby's health. Each is scored on a scale of 0 to 2, with 2 being the best score:
- Appearance (skin color)
- Pulse (heart rate)
- Grimace response (reflexes)
- Activity (muscle tone)
- Respiration (breathing rate and effort)
Apgar Scoring
Apgar Sign 2 1 0
Appearance
(skin color)Normal color all over (hands and feet are pink)Normal color (but hands and feet are bluish)Bluish-gray or pale all over
Pulse
(heart rate)Normal (above 100 beats per minute)Below 100 beats per minuteAbsent
(no pulse)
Grimace
("reflex irritability")Pulls away, sneezes, coughs, or cries with stimulationFacial movement only (grimace) with stimulationAbsent (no response to stimulation)
Activity
(muscle tone)Active, spontaneous movementArms and legs flexed with little movementNo movement, "floppy" tone
Respiration
(breathing rate and effort)Normal rate and effort, good crySlow or irregular breathing, weak cryAbsent (no breathing)What Does My Baby's Score Mean?A baby who scores a 7 or above on the test is considered in good health. A lower score does not mean that your baby is unhealthy. It means that your baby may need some immediate medical care, such as suctioning of the airways or oxygen to help him or her breathe better. Perfectly healthy babies sometimes have a lower-than-usual score, especially in the first few minutes after birth.
A slightly low score (especially at 1 minute) is common, especially in babies born:
- after a high-risk pregnancy
- through a C-section
- after a complicated labor and delivery
- prematurely
What if My Baby Has a Low Score?Many babies with low scores are perfectly healthy and do just fine after adjusting to life outside the womb.
If your doctor or midwife is concerned about your baby's score, he or she will let you know and will explain how your baby is doing, what might be causing problems (if any), and what care is being given.
What Else Do I Need to Know?This test was not designed to predict a baby's long-term health, behavior, intelligence, personality, or outcome. It was designed to help health care providers tell a newborn's overall physical condition so that they could quickly decide whether the baby needed immediate medical care.
With time to adjust to the new environment and with any necessary medical care, most babies do very well. So rather than focusing on a number, just enjoy your new baby!
Reviewed by: Mary L. Gavin, MD
Date reviewed: February 2018Note: All information on KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995-2018 The Nemours Foundation. All rights reserved.
Images provided by The Nemours Foundation, iStock, Getty Images, Veer, Shutterstock, and Clipart.com.
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