APGAR score – How to Calculate and Interpret?

Apgar score is the newborn assessment score.

As soon as your baby is born, the midwife will calculate an apgar score of your baby 2 times. At 1st minute and 5th minute. Depend on your baby situation, an additional 10th-minute score might be needed.

The 1st-minute score assesses the intrauterine condition. It tells you how well the baby tolerates the labor. Because labor is difficult both for the baby and the mother. Placental insufficiency and cord compression are the 2 most common conditions which can result in a low 1st-minute score.

The 5th-minute score assesses how well your baby adust with the new environment. Normally, a newborn makes physiologic changes to adjust to a new environment and the 5th-minute score will assess how well your baby does outside the uterus.

How to Calculate APGAR score?

It has 5 components and each graded as 0, 1, and 2. See the table below.

Apgar Score	0	1	2
A – Appearance	Blue or pale	Body pink, extrimity blue	All body parts are pink
P – Pulse (HR)	0	Less than 100	More than 100
G – Grimace (Reflex)	no	Grimace	Cough
A – Activity (Tone)	Limp	Some flextion	Active
R – Respiration (Effort)	Abscent	Slow and irregular	Adequate

How to Interpret?

The score is designed to assess if the newborn needs immediate resuscitation or not. It doesn’t predict the long term effect on the baby. Usually the less the score, the more resuscitation the baby needs. The 1-minute score assesses the placental or intrauterine situation and the 5th-minute score assesses how well the baby adjusts to the new environment.

So if the score is

• More than 7 score – good assessment. The baby is fine and can be with the mother with no additional resuscitation.
• 4 – 6 – intermittent – the baby needs some resuscitation to adjust to the new environment.
• 0 – 3 – low score – the baby needs extensive resuscitation to survive.