Apgar Score System

Apgar Score System, medical rating procedure developed in 1952 by American anesthesiologist Virginia Apgar to evaluate the condition of newborn infants and to identify those that require life-sustaining medical assistance, such as resuscitation. The Apgar score is a qualitative measurement of a newborn’s success in adapting to the environment outside the uterus and has had a large impact on the field of neonatology.

A newborn infant is evaluated one minute and five minutes after birth. Five signs are assessed: heart rate, respiratory effort, muscle tone, reflex irritability, and skin color. Medical students memorize these signs by using the mnemonic of Apgar’s name:

• appearance
• pulse
• grimace
• activity
• respiration

A score of 0, 1, or 2 is assigned to each component. Usually, the higher the total score, with 10 being the maximum, the better the infant’s condition. If the total score is less than 7, the infant is reevaluated every 5 minutes until 20 minutes have passed or until two successive scores of 7 or greater are obtained.

According to some researchers, the one- and five-minute Apgar scores are of limited use in predicting the degree of asphyxia (lack of oxygen or excess of carbon dioxide) or the consequences of any neurological involvement. Apgar scores taken at 10 or 15 minutes may be more successful indicators of an infant’s later neurological deficit.