Apgar score
The Apgar score is a quick assessment tool used to evaluate the health of newborns immediately after birth, focusing on five critical criteria: heart rate, respiratory effort, muscle tone, reflex response, and skin color. Each category is scored from 0 to 2, with the total score ranging from 0 to 10. Typically, the first Apgar score is taken one minute after birth, providing insight into the newborn's condition in the womb and the potential need for medical intervention. A score of seven to ten is considered normal, while lower scores may indicate a need for immediate care, such as airway clearance or oxygen therapy.
The second score is taken five minutes post-birth, with a score of three or lower associated with an increased risk of cerebral palsy, though the majority of infants with low scores do not experience long-term neurological issues. Research reveals that about 1.4 percent of infants score below seven at five minutes, with higher incidences among certain demographic groups, including young mothers and those lacking proper prenatal care. Importantly, the Apgar score reflects only the immediate need for medical attention and does not predict a child's future development or intelligence.
Apgar score
Anatomy or system affected: Circulatory system, heart, lungs, muscles, nervous system, respiratory system
Definition:Virginia Apgar, an obstetrical anesthesiologist, developed the Apgar score in 1952 to assess the clinical status of newborns
Indications and Procedures
The five categories evaluated by the Apgar score—heart rate, respiratory effort (breathing effort), muscle tone, response to stimulus (reflex response), and skin color—reflect functions necessary to sustain life. The accompanying table lists the components in descending order of importance. The Apgar score is the sum of scoring (0, 1, or 2) for each of the five parameters.
The first Apgar score is initially assigned one minute after birth. It reflects the baby’s condition in the womb and indicates the degree of medical intervention or resuscitation that may be required. A low one-minute score is not predictive of adverse neurologic outcomes. A low Apgar score may indicate a need for clearing of the airway or oxygen therapy to help with breathing or physical stimulation to improve the heart rate.
A second Apgar score is assigned five minutes after birth. A score of seven to ten is considered normal, while a score of four to six is considered borderline. A five-minute Apgar score of three or less has been associated with cerebral palsy in full-term infants; however, only approximately 4 to 5 percent of infants with low five-minute Apgar scores have long-term neurologic abnormalities. A stronger relationship exists between low Apgar scores and future neurologic disability when the assessment is taken at times greater than ten minutes after birth.
Perspective and Prospects
Approximately 1.4 percent of all babies have Apgar scores of less than seven at five minutes after birth. The highest proportions of infants with low Apgar scores at five minutes are among infants born to mothers under sixteen years of age or over forty years of age and to those who did not receive adequate prenatal care.
Current research using the Apgar score focuses increasingly on the neonatal heart rate and respiratory effort, looking for long-term subtle behavioral disabilities that may be associated with low and borderline Apgar scores. A newborn’s Apgar score is only an indicator of the level of intervention needed by medical staff on behalf of the baby, if any. It is not an indication of an individual’s future development, ability, or intelligence.
Bibliography
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