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The Apgar Score
What is it?

by Lisa Rodriguez, R.N. and Marjorie Greenfield, M.D.
reviewed and revised by Marjorie Greenfield, M.D.
As soon as your baby makes her way into this world, doctors or nurses will be assessing the basics: her temperature, heart rate and breathing. In addition, they will give her a numerical score at one minute and again at five minutes. These scores help the medical team assess how much (if any) medical help the baby needs in the first few minutes of life.

Developed by an anesthesiologist named Dr. Virginia Apgar, this test rates the baby 0, 1 or 2 points on each of five newborn characteristics:
  • Heart rate
  • Breathing
  • Muscle tone
  • Reflexes
  • Skin color
What does the Apgar score mean?

An Apgar score of 7 or better signifies that the baby is in good condition. If the baby rates between 4 and 6 at the 1-minute Apgar, she will usually need some help. Oxygen will be administered and she might have her airway suctioned. Those babies who score under 4 need more extraordinary measures of resuscitation. Narcotic medications, given to the mother for pain relief in labor, can contribute to a lower score.

Most of the time, if the Apgar score is low at one minute, by five minutes it's back to 7 or higher. If this is the case, the low one-minute score really means nothing: the baby will very probably do fine. If the Apgar score is still under 7 by five minutes, but comes up to 7 or above before 10 minutes, again, the baby will probably do well. Only if the Apgar score stays quite low for more than 10 minutes is there high likelihood of there being a real problem.

Many parents worry that their baby may not be OK if the Apgar score is low. Don't panic. The first ten minutes of life is a very resilient time for babies. Even those who have difficulties in this period generally do well. Pediatricians know that the Apgar score has no bearing at all on a child's future SAT scores, his personality, learning, or anything else.

If you are worried about your baby, or think that you heard something about the events during or after birth that puts your baby at risk, talk to your doctor. Many parents have worried needlessly due to misunderstandings about what they thought they heard the doctors and nurses say in the delivery room.
 RELATED INFORMATION
*  The Benefits of Breastfeeding
*  Fetal Assessment
*  Birth Procedures


Created September 10, 2000
Reviewed and revised August 24, 2004
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