In 1952, Dr. Virginia Apgar developed the A.P.G.A.R. score system as a rapid method to assess a newborn’s clinical status at one minute after birth and determine the need for immediate intervention to establish breathing [1]. Six years later, she and her colleagues published a second report evaluating a larger number of patients [2]. Healthcare providers assign the score at one and five minutes for all infants. If an infant’s score remains below seven, additional assessments continue at five-minute intervals until 20 minutes post-birth [3].
The Apgar Score evaluates five key indicators: heart rate, respiratory effort, muscle tone, reflex irritability, and skin color [4]. Each category receives a score between 0 and 2, with a maximum possible total of 10 [4]. Because it offers a standardized assessment, healthcare providers use it routinely to guide early neonatal care.
A.P.G.A.R. Score with Newborns
Approximately 90% of newborns score between 7 and 10, meaning they typically require no special intervention [4]. A low one-minute Apgar score suggests the need for immediate resuscitation, while an improvement by five minutes often signals a positive outcome. However, if an infant’s score remains low after 10 minutes, it may indicate serious complications requiring continued medical intervention and close monitoring.
Despite its widespread use, the Apgar score does not predict long-term neurological outcomes. Instead, it provides a critical first evaluation to ensure newborns receive the appropriate care in the moments following birth. By offering a quick and structured assessment, the Apgar score remains an essential tool in modern neonatal medicine.
- Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg 1953;32:260–267. [PubMed]
- Apgar V, Holiday DA, James LS, Weisbrot IM, Berrien C. Evaluation of the newborn infant: second report. JAMA 1958;168:1985–88. [PubMed]
- American Academy of Pediatrics and American Heart Association. Textbook of Neonatal Resuscitation. 6th edition. Elk Grove Village, IL: American Academy of Pediatrics and American Heart Association; 2011.
- American Academy of Pediatrics committee on fetus and newborn, American College of Obstetricians and Gynecologists committee on obstetric practice. The Apgar Score. Pediatrics. 2015 Oct;136(4):819-22.
