In childbirth classes, one of the topics pregnant families are likely to learn about is the Apgar Score. Named for anesthesiologist Dr. Virginia Apgar, who developed the score in 1952, the Apgar has long been used as a tool to evaluate a newborn baby’s condition at birth.

The score is generally assigned at one minute and five minutes after birth, but can be repeated if the scores are low. Two points each are given for the following:

• Color
• Heart Rate
• Reflex/Grimace
• Muscle Tone
• Respiratory Effort

There is a mnemonic that helps practitioners to remember the elements of the Apgar Score:

A – Appearance

P – Pulse

G – Grimace (Reflexes)

A – Activity (Tone)

R – Respiration

A score of 7-10 is generally considered reassuring; 4-6 is moderately abnormal, and 3 or below is considered low.

Fun fact: At elevation, such as here in Colorado, it is somewhat unusual to get a one minute score of 10, as many of our babies have blue hands and feet!

While the Apgar score can be one tool that tells the care provider whether a baby is in need of assistance, it isn’t necessarily a reliable predictor of long-term outcomes. In a recent article in the American Journal of Epidemiology, authored by Marit Bovbjerg, Melissa Cheyney, and Jennifer Brown (using information including that from one of our favorite projects – MANA Stats) the data did not appear to show that there was a consistent cut point in Apgar scores to be predictive of poor outcomes. More info on this can be found here.

The Apgar Score is but one of many useful tools that we employ to evaluate our newborns, but it is not the whole picture. Each baby’s condition should be evaluated according to their individual needs to determine the best approach to their care.