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Infant care following delivery
Infant care following delivery


Newborn test
Newborn test


Definition:

APGAR is a quick test performed at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score assesses how well the newborn is adapting to the new environment.

The rating is based on a total score of 1 to 10, with 10 suggesting the healthiest infant. Scores below 5 indicate that the infant needs immediate assistance in adjusting to his or her new environment.



Alternative Names:

Newborn scoring



How the test is performed:

Five categories are assessed:

  • Breathing effort
  • Heart rate
  • Muscle tone
  • Reflexes
  • Skin color

Each category is scored with 0, 1, or 2, depending on the observed condition.

  • Breathing effort:
    • If the infant is not breathing, the respiratory score is 0.
    • If the respirations are slow or irregular, the infant scores 1 for respiratory effort.
    • If the infant cries well, the respiratory score is 2.
  • Heart rate is evaluated by stethoscope. This is the most important assessment:
    • If there is no heartbeat, the infant scores 0 for heart rate.
    • If heart rate is less than 100 beats per minute, the infant scores 1 for heart rate.
    • If heart rate is greater than 100 beats per minute, the infant scores 2 for heart rate.
  • Muscle tone:
    • If muscles are loose and floppy, the infant scores 0 for muscle tone.
    • If there is some muscle tone, the infant scores 1.
    • If there is active motion, the infant scores 2 for muscle tone.
  • Reflex irritability is a term describing response to stimulation such as a mild pinch:
    • If there is no reaction, the infant scores 0 for reflex irritability.
    • If there is grimacing, the infant scores 1 for reflex irritability.
    • If there is grimacing and a cough, sneeze, or vigorous cry, the infant scores 2 for reflex irritability.
  • Skin color:
    • If the skin color is pale blue, the infant scores 0 for color.
    • If the body is pink and the extremities are blue, the infant scores 1 for color.
    • If the entire body is pink, the infant scores 2 for color.


How to prepare for the test:



How the test will feel:



Why the test is performed:

This test is a screening tool to determine whether a newborn needs help stabilizing.



Normal Values:

A score of 8 or 9 is normal and indicates the newborn is in good condition. A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for the transitional phase after birth.



What abnormal results mean:

Any score lower than 8 indicates the child needs assistance. However, a child who has a low score at 1 minute and a normal score at 5 minutes should not have any long-term problems.



What the risks are:

The APGAR test has no risks. It is very safe.



Special considerations:




Review Date: 11/14/2007
Reviewed By: Deirdre O’Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100