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Know All About The Apgar Score In Newborns

4 min read

There are several tests scheduled for the newborns to assess how healthy the baby is and if any immediate medical attention is required. Among these tests, the very first test performed on a newborn immediately after delivery, most probably in labor room itself is called – Apgar test. Read on to know all about this test.
apgar score

What Is The Apgar Test?

The Apgar test was developed by Dr.Virginia Apgar, who was an anesthesiologist. The APGAR is a scoring system, in which first general evaluation of the health of the baby is recorded. The Apgar test shows the doctors how healthy the baby is during the first moments of his life and if the baby requires any medical attention — and if he does, how soon the baby needs it. Apgar is an acronym.

  • A-Appearance, which refers to the color of the baby’s skin
  • P-Pulse, which refers to the heart rate of the baby
  • G-Grimace response, which medically refers to reflex irritability, a term describing response of the baby to the stimulations, such as a mild pinch
  • A-Activity , muscle tone
  • R-Respiration, which refers to breathing effort and rate of breathing

The Apgar test is generally done twice

  • The first test is done one minute right after baby’s birth
  • After five minutes of baby’s birth, the second test is performed. Even if the first test shows a low score, most of the time, by the second test is taken the scores will be normal

If the Apgar score during the first two test shows abnormal reading, the test is repeated 10 minutes after baby’s birth to confirm the reading.

What Is Apgar Score Chart ?

The score ranges from 0-2 for each category. The total number of categories (as explained above) is 5. Therefore, total score taken is out of ten. The test is simple and is performed by a nurse or doctor. Higher the Apgar score, healthier the baby is. However, babies seldom get ten out of ten score as the baby’s skin always have a blue tinge during the birth time. The scores 7, 8 or 9 is considered as normal. As the score goes below six (1 to 6), the baby needs medical attention. Lower the score, faster the medical attention.
Let us see how the scoring is being done. The table below will help to understand the scoring rules better.

‘The Apgar Score’ For Newborns
CategoryScore 2Score 1Score 0
Activity (evaluating the movement of the baby)The baby is very active with unprompted movementsArms and legs are flexed but with little movementLoose and Floppy tone with no movements
Pulse(Evaluating the heartbeat with a stethoscope)More than 100 heart beats per minuteLess than 100 beats per minuteNo heart beat
Grimace (Evaluating how the baby responds to stimulation like a light pinch)The baby sneezes or coughs and tries to pull away, and cries vigorously when lightly pinched.Only grimace when lightly pinched. No other reflex actions will happen.No response at all to any kind of stimulation
Appearance (Evaluating the skin color of the baby)Normal colored body.Pinkish feet and handsNormal colored body. There is a bluish tinge on the feet and handsSkin all over the body is pale or has a bluish-gray tinge
Respiration(Evaluating the breathing rate and breathing effort of the baby)Regular breathing and the baby will cry stronglySlow or irregular respiration and the baby’s cry will be weak, indicating high breathing effort.The infant is not breathing


What Do Apgar Scores Indicate?

If the baby gets a low score on his Apgar test (that is, under six), he may require oxygen or the baby’s airway should be cleared out or require some external stimulation to get the heart rate up. More often, a low score can be as a result of a difficult birth, aftereffect of a C-section, fluid in the baby’s airway.
newborn evaluated

  1. The 1- Minute Apgar Test Score
    • If the first Apgar score is between four and six, the baby needs help with breathing, which includes massaging, suctioning fluid from nostrils
    • If the first Apgar score is less than three, the baby requires immediate life-saving measures
  2. The 5- Minute Apgar Test Score
    • The Apgar score is repeated after 5 minutes to help the doctor to ascertain the baby’s response to the initial medical procedure. A score between seven and ten considered normal. Even if during the second test the reading remains low say below six, the doctor may decide health saving measures depending on the issue

The Apgar score does not indicate the future health of the baby. It merely indicates the health condition of the baby immediately after birth. Therefore, a low Apgar score does not necessarily indicate any long-term health issues.

What Are The Limitations Of The Apgar Score?

Apgar score may differ from doctor to doctor. One doctor may not give the same Apgar score to a newborn as another doctor. Apgar score is a mere indicator, your newborn baby may need other tests to determine his current health and his health in the future.
The chances of Apgar score being low can be due to the following reasons:

  • If you baby is born prematurely
  • Problems during pregnancy like any infection or injury due to a fall can cause low Apgar score
  • If you take certain medications, your newborn’s Apgar score can be low
  • If you have been dehydrated during labor and delivery, your newborn’s Apgar score will be low
  • If you newborn had trouble breathing right after his birth, he would have a low Apgar score
  • If your newborn had a medical problem during pregnancy, he would have a low Apgar score
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