Early screen test for newborn babies

CHECK-UP:APGAR score is used to determine how well the infant is adapting to its new environment

Can you tell me what an APGAR score is? When I recently gave birth to my daughter I heard the staff talking about this test.

The APGAR score is a quick screening test performed on newborn babies, usually at one and five minutes after birth. Performed at one minute it is used to assess how well the baby tolerated the birthing process, while the five-minute score determines how well the infant is adapting to its new environment. Five categories are assessed including breathing, heart rate, muscle tone, reflexes and skin colour. Each category is scored with zero, one or two, depending on the observed condition. The rating is based on a total score of one to 10, with 10 suggesting the healthiest infant. Scores below five indicate that the infant needs assistance in adjusting to his or her new environment.

Why is it called the APGAR score?

The test name is based on an acronym of Virginia Apgar’s name, an American anaesthetist and pioneer of neonatal care. Dr Apgar devised the scoring method in 1952, having noticed that babies were sent directly to the nursery without much formal assessment after delivery. She wanted the baby to be assessed in an organised and meaningful manner by the delivery room personnel. The initials of her surname were used to stand for the infant’s Appearance, Pulse, Grimace, Activity and Respiratory effort, the basis of the test.

Why is this test performed and what would be considered a normal result?

This test is a screening tool to determine whether a newborn needs help stabilising after the effort of birth. A score of eight or nine is normal and indicates the newborn is in good condition. A score of 10 is very unusual, since almost all newborns lose a point or two for blue hands and feet, which is normal for the phase immediately after birth. Any score lower than eight may indicate that the child needs assistance. However, a child who has a low score at one minute and a normal score at five minutes should not have any long-term problems. Although the APGAR score provides a convenient shorthand for reporting the status of the newborn infant and the response to resuscitation, it is not predictive of specific neurological problems in the term infant.

Are there any risks to the baby from the test?

No, the test has no risks associated with it.