APGAR

  • Definition

    APGAR is a quick test performed at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score assesses how well the newborn is adapting to the new environment.

    The rating is based on a total score of 1 to 10, with 10 suggesting the healthiest infant.


    Alternative Names

    Newborn scoring


    How the test is performed

    The APGAR test is done by a doctor, midwife, or nurse. The health care provider will examine the baby's:

    • Breathing effort
    • Heart rate
    • Muscle tone
    • Reflexes
    • Skin color

    Each category is scored with 0, 1, or 2, depending on the observed condition.

    • Breathing effort:
      • If the infant is not breathing, the respiratory score is 0.
      • If the respirations are slow or irregular, the infant scores 1 for respiratory effort.
      • If the infant cries well, the respiratory score is 2.
    • Heart rate is evaluated by stethoscope. This is the most important assessment:
      • If there is no heartbeat, the infant scores 0 for heart rate.
      • If heart rate is less than 100 beats per minute, the infant scores 1 for heart rate.
      • If heart rate is greater than 100 beats per minute, the infant scores 2 for heart rate.
    • Muscle tone:
      • If muscles are loose and floppy, the infant scores 0 for muscle tone.
      • If there is some muscle tone, the infant scores 1.
      • If there is active motion, the infant scores 2 for muscle tone.
    • Grimace response or reflex irritability is a term describing response to stimulation such as a mild pinch:
      • If there is no reaction, the infant scores 0 for reflex irritability.
      • If there is grimacing, the infant scores 1 for reflex irritability.
      • If there is grimacing and a cough, sneeze, or vigorous cry, the infant scores 2 for reflex irritability.
    • Skin color:
      • If the skin color is pale blue, the infant scores 0 for color.
      • If the body is pink and the extremities are blue, the infant scores 1 for color.
      • If the entire body is pink, the infant scores 2 for color.

    How to prepare for the test


    How the test will feel


    Why the test is performed

    This test is a screening tool to determine whether a newborn needs medical attention to stabilize the heart or breathing function.