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Instructions
The Apgar Score is used to assess the clinical status of a newborn immediately after birth. Enter values for Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration (breathing effort) to calculate the total score.
Overview
When to use
Why use
Evidences
Interpretation
Score | Interpretation |
0–3 | Severely depressed, requires immediate resuscitation |
4–6 | Moderately depressed, may need assisted ventilation or other support |
7–10 | Normal, indicates good overall condition |
The Apgar Score (Committee Opinion No. 644; reaffirmed/updated): Clarifies that Apgar summarizes newborn condition and response to resuscitation; it should not be used alone to define asphyxia or predict long‑term neurologic outcomes. Recommends scoring at 1 and 5 minutes, and if the 5‑minute Apgar is <7, continue every 5 minutes up to 20 minutes.
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/10/the-apgar-score
Weiner GM et al. 2020 AHA Guidelines for CPR and ECC: Neonatal Resuscitation. Emphasizes initiating resuscitation based on respirations, heart rate, and tone, not waiting for an Apgar value; Apgar is documented to reflect condition and response.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000000895
Casey BM et al. The continuing value of the Apgar score for the assessment of the newborn infant. N Engl J Med. 2001;344:467–71. Lower 5‑minute Apgar associated with higher neonatal morbidity and mortality at a population level, while individual prognostication is limited.
https://www.nejm.org/doi/full/10.1056/NEJM200102153440701
Overview
When to use
Why use
Evidences
The Apgar Score is one of the most widely used tools in neonatal medicine, designed to provide a quick and systematic assessment of a newborn’s condition at birth. It was introduced in 1952 by Dr. Virginia Apgar as a simple, standardized method for evaluating the need for immediate medical intervention. The score is determined at 1 minute and 5 minutes after delivery, with a possible range from 0 to 10.
The assessment is based on five key criteria: skin color (Appearance), heart rate (Pulse), reflex response to stimulation (Grimace), muscle tone (Activity), and breathing effort (Respiration). Each parameter is assigned a value of 0, 1, or 2, and the sum provides the overall Apgar Score. A higher score indicates better neonatal health.
While the Apgar Score is not intended to predict long-term health outcomes, it is extremely valuable for guiding immediate clinical care in the delivery room. Scores obtained at 1 minute provide insight into the infant’s initial response to extrauterine life, while 5-minute scores are better indicators of the newborn’s adaptation and the effectiveness of interventions. Additional assessments may be done at 10 minutes if needed.
Overview
When to use
Why use
Evidences
Interpretation
Score | Interpretation |
0–3 | Severely depressed, requires immediate resuscitation |
4–6 | Moderately depressed, may need assisted ventilation or other support |
7–10 | Normal, indicates good overall condition |
The Apgar Score (Committee Opinion No. 644; reaffirmed/updated): Clarifies that Apgar summarizes newborn condition and response to resuscitation; it should not be used alone to define asphyxia or predict long‑term neurologic outcomes. Recommends scoring at 1 and 5 minutes, and if the 5‑minute Apgar is <7, continue every 5 minutes up to 20 minutes.
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/10/the-apgar-score
Weiner GM et al. 2020 AHA Guidelines for CPR and ECC: Neonatal Resuscitation. Emphasizes initiating resuscitation based on respirations, heart rate, and tone, not waiting for an Apgar value; Apgar is documented to reflect condition and response.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000000895
Casey BM et al. The continuing value of the Apgar score for the assessment of the newborn infant. N Engl J Med. 2001;344:467–71. Lower 5‑minute Apgar associated with higher neonatal morbidity and mortality at a population level, while individual prognostication is limited.
https://www.nejm.org/doi/full/10.1056/NEJM200102153440701
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