APGAR SCORE

In 1952, Dr. Virginia Apgar, an anesthesiologist, devised the Apgar score to quickly and summarily assess the health of a newborn immediately after birth. The development of the score was originally to ascertain the effects of obstetric anesthesia on babies.
The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five obtained values. The resulting Apgar score ranges from zero to 10. The five criteria are Appearance, Pulse, Grimace, Activity, and Respiration.

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The test is generally done at one and five minutes after birth, and may be repeated later if the score is and remains low. Scores 3 and below are mainly regarded as critically low, 4 to 6 moderately low, and 7 to 10 generally normal.


A low score on the one-minute test may show that the neonate requires immediate medical attention but is not necessarily an indication that there will be long-term problems, particularly if there is an improvement by the stage of the five-minute test. There is a risk that the child will suffer longer-term neurological damage if the Apgar score remains below 3 at later times such as 10, 15, or 30 minutes,. There could be a small significant increase risk of cerebral palsy. The purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care. This was not designed to make a long-term prediction on a child's health.


An Apgar score of 10 is not common because of the prevalence of transient cyanosis, and is not substantially different from an Apgar score of 9. Transient cyanosis is common, particularly in babies born at high altitude.


A study was conducted in Peru by comparing babies born near sea level with babies born at very high altitude approximately 4340 meters found a significant difference in the first but not the second Apgar score. Oxygen saturation was also lower at high altitude.