What is the Apgar score?

The Apgar score is a test used by doctors and midwives to assess your baby's health when they are born. It helps to work out if your baby needs emergency care.

The Apgar score is used to check a newborn baby at 1 minute, 5 minutes and (if required) 10 minutes after birth.

The test is named after Dr Virginia Apgar, who developed the score in 1952.

What does the Apgar score measure?

The Apgar score rates your baby's:

• skin colour
• heart rate
• reflexes and responsiveness
• muscle tone
• breathing rate

How is the Apgar score measured?

Each sign is scored from 0 to 2, with 2 being the best score. The scores for each sign are added together to give a total Apgar score out of 10.

Sign	0	1	2
Skin colour	Blue or pale body	Blue hands and feet	Completely pink
Heart rate	Absent	<100 beats per minute	>100 beats per minute
Reflexes and responsiveness	No response	Grimace (expressive)	Cry or active withdrawal
Muscle tone	Completely limp	Some flexion	Active motion
Breathing rate	Absent	Irregular or shallow breathing, weak cry	Good breathing effort, crying

Blue hands and feet can be normal for a newborn in their first 24 hours. This is why the highest Apgar score is usually 9.

What does the Apgar score mean?

An Apgar score of 7 or more, 5 minutes after birth, shows that your baby is adapting well after birth. However, a score below 7 at 5 minutes is considered low.

If your baby's Apgar score is low at 5 minutes, the doctors will continue to closely monitor your baby.

What happens if my baby scores low on the Apgar test?

If your baby has a low Apgar score, they may need extra medical help.

Babies with an Apgar score of less than 7 are more likely to need:

• extra support with breathing
• admission to the special care nursery or neonatal intensive care unit

The Apgar score is just one way to check your baby after birth.

What causes a low Apgar score?

There are many factors that impact an Apgar score. These include:

• health conditions or medicines affecting the mother
• factors that affect the baby — such as being premature
• the type of birth

It's worth remembering that the Apgar score reflects your baby's condition only at one point in time. It can also be quite subjective. This means that there may be differences in the scores calculated by different doctors and nurses.

Does the Apgar score predict future health problems?

Apgar scores are intended to check the immediate health of newborn babies. They are used to monitor babies and to make sure that they are getting all the care they need straight after birth.

Apgar scores are not intended to predict neurological outcomes and should not be used for that purpose.

Resources and support

If you have any concerns, speak with your doctor, midwife or nurse.