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APGAR Score

Newborn physiological assessment at 1 and 5 minutes post-birth.

Switch how results are explained

Appearance (Skin Color)
Pulse (Heart Rate)
Grimace (Reflex Irritability)
Activity (Muscle Tone)
Respiration (Breathing Effort)
Score10low risk
low riskmoderate riskhigh risk

Normal score (7–10). Routine post-natal care, drying, warming, and ongoing monitoring.

Evidence grade
A

What it is and when to use it

The APGAR score was devised by Dr. Virginia Apgar in 1953 as a rapid, standardized assessment of a newborn's condition immediately after birth. It evaluates five parameters (Appearance, Pulse, Grimace, Activity, Respiration), scored from 0 to 2 each, yielding a total score from 0 to 10.

How to interpret it

Scores of 7 to 10 are considered normal and reassuring. Scores of 4 to 6 indicate moderate physiological depression, prompting tactile stimulation, airway clearing, or oxygen. Scores of 0 to 3 reflect severe depression and warrant immediate resuscitation per Neonatal Resuscitation Program (NRP) protocols.

Limitations and when not to use it

The APGAR score is intended to report post-birth status and response to resuscitation; it should NOT be used to dictate initial resuscitation measures or predict individual long-term neurological outcome.

Frequently asked questions

When is the APGAR score calculated?
It is routinely performed at 1 minute and 5 minutes after birth. If the 5-minute score is under 7, additional assessments may be performed every 5 minutes up to 20 minutes.
Does a low APGAR score mean my baby will have long-term health issues?
Not necessarily. Most infants with low 1-minute APGAR scores respond rapidly to medical assistance and score normally by 5 or 10 minutes.

Formulas and cut-offs are from the original authors of each score; see the references.

Last reviewed: June 2026

References
  1. Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32(4):260-267. PMID:13083014