APGAR

APGAR
Photo by Tim Bish / Unsplash

The APGAR score is used to assess a newborn’s clinical status at 1 and 5 minutes after birth. It helps determine whether resuscitation is needed and monitors neonatal adaptation to extrauterine life.

Category 0 Points 1 Point 2 Points
Appearance (Color) Blue or pale all over Body pink, extremities blue (acrocyanosis) Completely pink
Pulse (HR) Absent <100 bpm ≥100 bpm
Grimace (Reflex Irritability) No response to stimulation Grimace/weak cry to stimulation Strong cry, pulls away, cough, sneeze
Activity (Muscle Tone) Limp, no movement Some flexion of arms and legs Active movement
Respiration (Effort) Absent Slow or irregular breathing Strong, regular cry
Score Interpretation
7–10 Normal; routine postnatal care
4–6 Moderate distress; may need support
0–3 Severe distress; immediate resuscitation

Example:

A newborn at 1 minute has:

  • Blue extremities, pink body → 1 point (Appearance)
  • HR 110 → 2 points (Pulse)
  • Grimaces to stimulation → 1 point (Grimace)
  • Some flexion → 1 point (Activity)
  • Weak, irregular cry → 1 point (Respiration)

Total APGAR score = 2 + 1 + 1 + 1 + 1 = 6