Life is full of examinations and tests. This holds true for every human being, be it the oldies, youngsters, or even the babies. Just after a baby is born, it is put to its first exam with the APGAR score which it is required to pass with flying colors, else its life is at risk. The APGAR score, developed by the distinguished anesthesiologist Dr. Virginia Apgar in 1952, is a simple method and technique for monitoring the physical condition of a newborn baby immediately after delivery and whether or not a baby requires any instantaneous extra medical or emergency care. APGAR is an acronym for Activity, Pulse, Grimace, Appearance, and Respiration. The APGAR test has gained worldwide recognition and acceptance and is performed one minute after childbirth and repeated again after five minutes. The score so obtained determines the general condition of the baby and its post-delivery care. Though it is highly useful across the world, do not expect your baby to score a 100 in this test as the tiny tots rarely score well. Read on further to know how to interpret the APGAR score and understand its significance.
The APGAR test evaluates the baby’s condition on five different parameters, namely, baby’s color, heart rate, reflex response, muscle tone, and breathing. Each parameter is given a score of 0, 1, or 2, with a final score, to be evaluated, out of 10. At one-minute APGAR test, if a baby scores between 7 and 10, it is in good condition and requires only routine post-delivery care. A score between 4 and 6 indicates that the baby requires some breathing assistance. This can be given by providing it with oxygen, suctioning its nostrils, or massaging it. A score below 4 means that the baby needs immediate lifesaving measures, such as resuscitation. However, remember, a low score at one minute does not necessarily mean that your baby is at risk. When babies are born prematurely or delivered through caesarean section, they are likely to show a low score at one-minute APGAR test, which is absolutely normal.
The APGAR test is repeated after five minutes to see the progress of the baby and whether it is responding to any initial medical assistance. It acts as a good predictor of the baby’s survival and development in early infancy. A baby scoring between 7 and 10 is yet again considered normal. However, any baby with a score of 6 or below, at second APGAR test, is at risk and requires serious medical help. In such circumstances, the practitioner generally suggests steps to be taken to improve the baby’s condition. The first 5 to 10 minutes are extremely important for a baby after it is delivered and hence, this APGAR score enables the doctor to find out how the baby is doing and whether it needs extra medical support to breathe or not. While it was in the womb, the baby was breathing and receiving oxygen and nutrition through the umbilical cord, however, after the delivery, the environment of the baby drastically changes as it comes out of the safety of the womb to the world at large. Also, post delivery, all the functions need to be performed by the baby. It has to use its lungs to breathe. As such, the first few breaths and color of the skin is observed to determine the functioning of the lungs and the delivery of oxygen from the air through the lungs to the baby.
Babies are rated in the following manner:
Activity (Muscle Tone)
0 - Limp; no movement
1 - Some flexion of arms and legs
2 - Active motion
Pulse (Heart Rate)
0 - No heart rate
1 - Fewer than 100 beats per minute
2 - At least 100 beats per minute
Grimace (Reflex Response)
0 - No response to airways being suctioned
1 - Grimace during suctioning
2 - Grimace and pull away, cough, or sneeze during suctioning
Appearance (Baby’s Color)
0 - The baby's whole body is completely bluish-gray or pale
1 - Good color in body with bluish hands or feet
2 - Good color all over
0 - Not breathing
1 - Weak cry; may sound like whimpering, slow or irregular breathing
2 - Good, strong cry; normal rate and effort of breathing
The APGAR scores should not be used to predict whether or not your baby will lead a shorter or longer life. However, with your support, your baby can nurture into a happy individual and become a healthy person.