The APGAR: the First Test a Baby ever Takes

Many parents do not realize it, but their child takes his first test one minute after being born. This test does not indicate intelligence or future performance. It is simply a measure of the baby’s overall health. The APGAR test was created by an obstetric anesthesiologist named Virginia Apgar in 1952. This test has since become the standard for measuring the overall wellbeing of newborns worldwide.

The APGAR is performed as soon as the baby is born with scores recorded at one minute and five minutes of life. The APGAR scores are used by doctors to determine what medical treatments the baby may require immediately. The five minute APGAR measures how well the baby has responded if resuscitation is needed.

The APGAR assesses the color, heart rate, muscle tone, reflex, and respiratory efforts of the baby with scores assigned from 0 to 2 for each item. Scores from 7 – 10 mean that the baby is healthy and won’t require any special care other than that normally provided to newborns. Scores in the 4-6 range may indicate the need for the baby to receive assistance with breathing.

Scores below 4 indicate the need to take lifesaving steps. At five minutes, most babies score in the 7-10 range. Babies scoring below 7 will be monitored and assessed again at five minute intervals. Low scores do not indicate any permanent problems that will affect the baby in the future.

The following is a list of assessment items and a breakdown of the scoring system as defined by Virginia Apgar:

Heart Rate

- 0  No Heart Rate
- 1  Slow Heart Rate – Less than 100 bpm baby is not very responsive
- 2  Normal Heart Rate – More than 100 bpm baby is quite vigorous

Respiration

- 0  Baby is not Breathin
- 1  Weak cry; may sound like whimpering or grunting
- 2  Good, strong cry

Muscle tone

- 0  Limp
- 1  Some flexing or bending of arms and legs
- 2  Baby moves actively

Reflex response

- 0  Does not respond to airway stimulation
- 1  Grimaces during stimulation
- 2  Grimaces and coughs or sneezes during stimulation

Color

- 0  Baby is completely blue or pale
- 1  Baby has good color in body with blue hands or feet
- 2  Baby is complete pink or good color