The Apgar score is determined by evaluating a newborn on five criteria, with each criterion scored on a scale of 0 to 2. The Apgar score assesses for signs of hemodynamic compromise, including cyanosis, hypoperfusion, bradycardia, hypotonia, respiratory depression, or apnea.
Here’s a breakdown of the scoring:
Apgar Score Components
| Sign | 0 | 1 | 2 |
|---|---|---|---|
| Appearance (Color) | Blue or pale all over | Body pink, extremities blue | Completely pink |
| Pulse (Heart Rate) | Absent | Slow (below 100 beats per minute) | Over 100 beats per minute |
| Grimace (Reflex irritability) | No response to stimulation | Grimace or weak cry when stimulated | Crying or pulling away when stimulated |
| Activity (Muscle Tone) | Limp | Some flexion | Active movement |
| Respiration (Breathing) | Absent | Slow or irregular | Strong cry |
-
Appearance (Color): This refers to the baby’s skin color.
- 0: The baby is blue or pale all over.
- 1: The baby's body is pink, but the extremities are blue (acrocyanosis).
- 2: The baby is completely pink.
-
Pulse (Heart Rate): This measures the baby's heart rate.
- 0: No heart rate.
- 1: Heart rate is slow (below 100 beats per minute).
- 2: Heart rate is normal (above 100 beats per minute).
-
Grimace (Reflex Irritability): This evaluates the baby’s response to stimulation.
- 0: No response.
- 1: Grimace or weak cry.
- 2: Crying or pulling away.
-
Activity (Muscle Tone): This assesses the baby's muscle tone.
- 0: Limp muscle tone.
- 1: Some flexion of the extremities.
- 2: Active movement.
-
Respiration (Breathing): This measures the baby's breathing effort.
- 0: Not breathing.
- 1: Slow or irregular breathing.
- 2: Strong cry.
The Apgar score is typically assessed at 1 minute and 5 minutes after birth.
