All About the Apgar Score

The Apgar score, the very first test given to a newborn, occurs in the delivery room immediately after the delivery of the baby. It is a simple and painless rating system to evaluate your newborn’s health.  In 1952, Virginia Apgar first developed the test to standardize assessment of newborns after anesthesia was administered to mothers. It allowed medical professionals to quickly determine a newborn’s physical state and decide if any additional medical care or emergency intervention was needed.

“Being delivered and adapting to life outside the womb is one of the most physiologically stressful moments in the human body, but babies were born to make the necessary major cardiovascular adjustments during the first few minutes of life in coordination with baby’s first breath,” says Ginny Dalton, NICU Clinical Nurse Manager of the Kettering Medical Center.  The Apgar test is typically administered one minute after birth and again five minutes after birth. Apgar scores are assigned at 1 minute, 5 minutes, 10 minutes and five minute intervals thereafter, until two scores greater than or equal to 7 are assigned.

The Apgar test is often referred to as an acronym for: Appearance, Pulse, Grimace, Activity, and Respiration. Each of these five factors are scored on a scale of 0 to 2 with 2 being the highest score. Doctors, nurses or midwives combine these five factors to determine the baby’s Apgar score, a number between 10 and 0.  A score of 8 or above is ideal. It’s important to note that a lower score does not necessarily indicate poor health. It might simply mean the baby needs special care such as airways cleared or additional oxygen to help him or her breathe.  “Commonly it is only necessary for the newborn to be dried, warmed and stimulated by rubbing on the back or flicking of the heels. It is not uncommon for some newborns to require extra stimulation or suctioning of the mouth, nose and airway through or after 1 minute of life. If a baby has a low 1-minute Apgar, it does not mean the 5-minute Apgar won’t be significantly improved,” explains Dalton.  The 1-minute score indicates how well the baby tolerated the delivery. The 5-minute score determines how the baby is coping outside the mother’s womb. The test may rarely be done 10 minutes after birth. Typically, a low score at 1 minute is close to normal by 5 minutes.

Some babies adjust to life outside the womb more gradually. Others are born with health conditions that demand extra medical attention. The majority of newborn babies who initially have low Apgar scores are eventually perfectly healthy. A lower Apgar score is common for newborns who were born after a high-risk pregnancy, complicated labor or delivery by cesarean section. Fluid in the newborn’s lungs or premature delivery can also be contributing factors toward a low Apgar score. A lower Apgar score does not indicate if a child will have serious significant health problem, as it is not designed to predict a child’s future health.

“The medical team caring for the newborn after delivery will stay with and assess the newborn for up to at least 5 minutes of life. One’s obstetrician, midwife or nurse will help guide through the delivery, during which many factors may impact the Apgar scores related to the patient’s status during and after delivery,” says Dalton. “The key is to allow the delivering professional and the newborn resuscitation team to function simultaneously and in coordination with the delivering mother to help assure quality care.”

Leave a Reply

Your email address will not be published. Required fields are marked *