About the APGAR Score
The APGAR score is a quick, standardized way to summarize a newborn's condition in the first minutes after birth. Introduced by anesthesiologist Virginia Apgar in 1952, it rates five signs, each on a 0-1-2 scale, and adds them for a total from 0 to 10. The word APGAR doubles as a mnemonic: Appearance, Pulse, Grimace, Activity, and Respiration.
How the score is calculated
Each of the five signs is scored independently, then the five values are summed. There are no weights or multipliers - the total is a simple addition, so the maximum is 10 (a 2 on every sign) and the minimum is 0.
- Appearance (skin color): 0 = blue or pale all over; 1 = body pink with blue extremities; 2 = completely pink.
- Pulse (heart rate): 0 = absent; 1 = below 100 bpm; 2 = 100 bpm or above.
- Grimace (reflex response): 0 = no response to stimulation; 1 = grimace or feeble cry; 2 = cry, cough, or sneeze and pulls away.
- Activity (muscle tone): 0 = limp; 1 = some flexion of the limbs; 2 = active motion with flexed limbs.
- Respiration (breathing effort): 0 = absent; 1 = slow or irregular with a weak cry; 2 = good, strong cry.
Interpreting the total
- 7 to 10 is generally reassuring and the most common result for healthy newborns.
- 4 to 6 is moderately low and typically prompts closer observation and support.
- 0 to 3 is critically low. The score is normally recorded at 1 minute and again at 5 minutes; a 5-minute score below 7 is often reassessed every 5 minutes up to 20 minutes.
The APGAR score describes the newborn's condition at a moment in time. It is not designed to predict long-term health, and it is not by itself the trigger for resuscitation, which follows separate clinical protocols.
Important disclaimer
This tool is for educational and informational use and does not constitute medical advice. Scoring and any decisions about newborn care should be carried out by a qualified healthcare professional.