Definition The APGAR score is a quick test performed on the infant immediately after delivery at 1, 5 and sometimes 10 minutes after birth to determine the physical condition of the newborn.
Who is a candidate for the test? All babies delivered in a hospital or birthing centre undergo APGAR testing by trained delivery room personnel. The test is performed as a screening tool for doctors to determine what medical assistance may be needed to stabilise the newborn in distress.
How is the test performed? The APGAR score is based on the evaluation of 5 characteristics of the infant, at 1 minute and 5 minutes routinely. If foetal distress was present during labour and delivery, a 10-minute score may also be performed. Each observation receives 0, 1 or 2 points depending upon the health of the infant. These measurements and observations include:
heart rate (0 = no heart beat; 1 = heart rate less than 100; 2= heart rate more than 100)
respiratory effort (0 = no respirations; 1 = slow, irregular breathing; 2 = crying with respirations)
muscle tone ( 0 = flaccid; 1 = some flexion of extremities; 2 = active motion)
reflex irritability - level of newborn irritation in response to stimuli ( 0 = no response; 1 = grimacing; 2 = vigorous cry)
colour ( 0 = pale blue; 1 = body is pink, but extremities are blue; 2 = body and extremities are pink)
What do the test results mean? The 1-minute APGAR score assesses how well the newborn tolerated the labour and birthing process, whether it was a vaginal or caesarean delivery. The 5-minute APGAR score assesses how well the newborn is adapting to the physical environment outside the mother's womb. A score of 8 to 10 is normal, indicating a healthy, vigorous infant, but a score of "10" is highly unusual as most babies are a bit blue upon delivery. Any score less than 7 by the 5-minute check indicates that the newborn may need some assistance in stabilising to the environment. Assistance may include:
continued monitoring and observation in the nursery
continued heart rate monitoring (ECG)or pulse oximetry (blood oxygen monitor)
IV fluids
glucose feedings
antibiotics
blood tests
Premature infants, multiple gestations, intrauterine growth retardation and infants subjected to prolonged oxygen deprivation in labour are subject to having lower APGAR scores and possible complications.
Author: Eva Martin, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
