Designed in 1952 by Dr. Virginia Apgar, the APGAR score is a quick test performed at 1 and 5 minutes after birth to determine the physical condition of the newborn. The rating is based on a scale of 1 to 10. 10 suggests the healthiest infant, and scores below 5 indicate the infant needs immediate assistance in adjusting to the new environment.

• heart rate
• respiratory effort
• muscle tone
• reflex irritability
• color

• Heart Rate: Heart rate is evaluated by stethoscope. This is the most important assessment.
  • If there is no heart beat, the infant scores 0 for heart rate.
  • If there is a heart beat less than 100 beats per minute, the infant scores 1 for heart rate.
  • If there is a heart beat greater than 100 beats per minute, the infant scores 2 for heart rate.
• Respiratory Effort:
  • If there are no respirations, the infant scores 0 for respiratory effort.
  • If the respirations are slow or irregular, the infant scores 1 for respiratory effort.
  • If there is good crying, the infant scores 2 for respiratory effort.
• Muscle Tone:
  • If the muscle tone is flaccid, the infant scores 0 for muscle tone.
  • If there is some flexion of the extremities, the infant scores 1 for muscle tone.
  • If there is active motion, the infant score 2 for muscle tone.
• Reflex Irritability: Reflex irritability is a term describing the level of newborn irritation in response to stimuli (such as a mild pinch).
  • If there is no reflex irritability, the infant scores 0 for reflex irritability.
  • If there is grimacing, the infant scores 1 for reflex irritability.
  • If there is grimacing and a cough, sneeze or a vigorous cry, the infant scores 2 for reflex irritability.
• Color:
  • If the color is pale blue, the infant scores 0 for color.
  • If the body is pink and the extremities are blue, the infant scores 1 for color.
  • If the entire body is pink, the infant scores 2 for color.

The 1-minute APGAR score assesses how well the newborn tolerated the birthing process. The 5-minute APGAR score assesses how well the newborn is adapting to the environment.

This test is a screening tool for health care providers to determine what assistance is immediately necessary to help your newborn stabilize.

A score of 8 to 10 is normal and indicates your newborn is in good condition. A score of 10 is very unusual. Almost all newborns lose 1 point for blue hands and feet.

Any score less than 8 indicates your child needs assistance stabilizing. A low score at 1 minute that normalizes by 5 minutes is not clearly associated with any long-term negative effects.