The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two and summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10.
{| align=center border=1 cellspacing=0
!
!Score 0
!Score 1
!Score 2
|- align=center
!align=left|Heart rate
|absent||<100||>100
|- align=center
!align=left|Respiration
|absent||weak or irregular||strong
|- align=center
!align=left|Muscle tone
|none||some flexion||active movement
|- align=center
!align=left|Reflex irritability
|no response
to stimulation
|grimace/feeble cry
when stimulated
|sneeze/cough/pulls away
when stimulated
|- align=center
!align=left|Skin color
|blue all over||blue at extremities||normal
|+ bgcolor=#abcdef|The five criteria of the Apgar score
|}
The test is generally done at 1 and 5 minutes after birth, and may be repeated later if the score is, and remains, low. Scores below 3 are generally regarded as critically low, with 4 – 7 fairly low and over 7 generally normal.
Low scores at the one minute test may require medical attention, but are not a an indication of longer term problems, particularly if there is an improvement by the stage of the five minute test. Certainly if the Apgar score remains below 3 for the longer periods 10 minutes, 15 mins, 30 mins etc., there is a risk that the child will suffer longer term neurological damage. There is also a small but significant increase in the risk of cerebral palsy. However, the purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care; it was not designed to make long–term predictions on a child's health.
Some ten years after the initial publication, the acronym APGAR was coined in the US as a mnemonic learning aid: Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration.
Literature
See also