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What is the APGAR Score?

APGAR is a quick test that is usually performed on newborns when they are 1 and 5 minutes. old. These tests are often performed to assess the baby’s overall health condition. The test performed one minute after birth determines how well the baby tolerated labor whereas that performed at 5 minutes indicates how well the baby is thriving out of the womb.

The APGAR test particularly focuses on five major categories, including breathing effort (respiration), heart rate (pulse), muscle tone (activity), reflexes and skin color. For each category, the baby can score from zero (0) to two (2) points, depending on his condition. However, the overall APGAR test is ten (10), given that each category gives a maximum of two points.

The test is usually done by a doctor, nurse or midwife and points are awarded as follows:

Breathing/Respiratory

  •         Zero (0) point if the baby is not breathing at all
  •         One (1) point if the breathing is slow, irregular, and coupled with weak crying.
  •         Two (2) points if the infant cries well.

Heart rate / Pulse

  •         Zero (0) point if there is no heart activity
  •         One (1) point if the heartbeat is less than 100 per minute
  •         Two (2) points if the heartbeat is greater than 100 per minute.

Muscle tone / Activity

  •         Zero (0) point for loose and floppy muscles
  •         One (1) point for loose muscle activity
  •         Two points (2) for active movement.

Reflexes

  •         Zero (0) point if there is no reaction to simulation
  •         One point (1) if there is some facial movement and reaction to stimulation
  •         Two (2) points if there is crying, coughing, sneezing and ability to react to stimulation.

Skin Color

  •         Zero (0) point if the baby’s skin is pale, blue or bluish-grey
  •         One (1) point if the baby’s color is pink with blue extremities
  •         Two (2) points if the baby’s skin is pink all over.

An APGAR score of 7 is reassuring while a score of between 4 and 6 is considered moderately abnormal. Scores of 0 to 5 are extremely concerning and such babies often need interventions such as oxygen or could be transferred to the neonatal intensive care unit.

Although the APGAR score determines how well the baby is thriving immediately after birth, it doesn’t reflect the baby’s overall health in the long run.

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