Apgar Score: Methods Used To Evaluate Newborn Condition

This scoring system is a useful clinical tool to identify those neonates who require resuscitation as well as to assess the effectiveness of any resuscitative measures. As shown in Table below, each of the five easily identifiable characteristics—heart rate, respiratory effort, muscle tone, reflex irritability, and color—is assessed and assigned a value of 0 to 2. The total score, based on the sum of the five components, is determined 1 and 5 minutes after delivery. 

Apgar Scoring System

Sign 0 Points 1 Point 2 Points Heart rate Absent < 100 bpm ≥ 100 bpm Respiratory effort Absent Slow, irregular Good, crying Muscle tone Flaccid Some flexion of extremities Active motion Reflex irritability No response Grimace Vigorous cry Color Blue, pale Body pink, extremities blue Completely pink

The 1-minute Apgar score reflects the need for immediate resuscitation. The 5-minute score, and particularly the change in score between 1 and 5 minutes, is a useful index of the effectiveness of resuscitative efforts. The 5-minute Apgar score also has prognostic significance for neonatal survival, because survival is related closely to the condition of the neonate in the delivery room.

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