Apgar score - assessment of babies at birth

Apgar score is a method of assessing the condition of a newborn immediately after birth, so that the newborn receives appropriate assistance, if necessary. A low score in the first minutes usually does not mean that the child will have some developmental problems later, and a high score is not in itself a guarantee of the expected psychomotor development.

What is the APGAR score and how is it determined

In 1952, anesthesiologist Dr. Virginia Apgar devised a rapid and comprehensive method for assessing the vitality of the newborn immediately after birth, aiming to focus the attention of delivery room staff on the newborn too.

The APGAR score is a number/score calculated by assessing five clinical signs in a newborn: heart rate, respiratory movements, reflex reactions (baby's reaction to a catheter in the nose), muscle tone, and skin color.

Each score parameter can be rated 0, 1, or 2, so that the total score can be 0-10. The APGAR score is determined 60 seconds after the complete birth of the child, as well as after 5 minutes. Score values of 8-10 indicate that the newborn is in excellent condition and only needs routine care in the delivery room. Values of 5-7 indicate that the baby is a little "tired", while values of 0-4 mean that the newborn needs immediate assistance. If, despite the resuscitation measures taken, the score remains low, i.e. the baby does not recover, the score is determined again after 10, 15 and 20 minutes, in parallel with the application of the necessary resuscitation procedures.

The APGAR score in 1st minute only serves the staff attending the birth as an aid in assessing whether the child needs any of the support measures. The APGAR score in 5th minute serves to assess the child's recovery and reaction to the resuscitation measures taken and has no great prognostic significance. Only a prolonged low score has prognostic significance.

To understand the importance of "birth assessment", it is important to know:

  • The APGAR score is a subjective method.
  • It is not completely adapted to preterm babies
  • Newborn depression caused by medications received by the mother during childbirth can also affect the assessment values (painkillers, anesthetics, sedatives).
  • Although many babies get a "perfect ten", there are really few babies who actually get a 10 in 5th minute, and especially in 1st minute.
  • A score of 8 or 9 is excellent and has the same value as a ten.
  • The APGAR score in 5th, 10th and 30th minute provides a better insight into the newborn's adaptation to life in the external environment and has a better prognostic value. A low score is a signal to the pediatrician to monitor the baby's psychomotor development more intensively.

There are many factors that affect the development of the child during life in the mother's womb and there is no score or method that immediately after birth can provide a complete insight into the child's condition and all its developmental potentials.