Importantly, this test was not designed to predict a baby’s health, behavior, intelligence, personality, or long-term outcome, but to help healthcare professionals understand their physical condition and quickly decide if they need immediate medical attention.
A baby is generally considered to be in good health if she scores eight or higher. Typically, when the test is done in the first minute, the score is low, and therefore, 5 minutes after birth, the score is recalculated. If this continues to be low and has not improved, health professionals will continue the necessary medical care and monitor the baby closely.
A Newborn Baby Also, very few babies get a perfect 10, as their hands and feet often stay blue until warm. Perfectly healthy babies sometimes score lower than usual, especially in the first few minutes.
Some babies are born with conditions that require additional medical attention, but others only take a little longer than usual to adjust to life outside the womb. This is why some babies score low when the test is done at minute one.
Thus, having a lower score does not mean that she is not healthy or abnormal since, in some cases, it can simply mean that she needs some immediate special care, such as oxygen, to help her breathe. Some of the children most at risk for low scores are premature babies, cesarean deliveries, or those who, during delivery, experienced problems with their heart or respiratory system.
Similarly, parents should not worry if their baby receives a low score, especially during the first few minutes, as this does not mean that a child is sick. However, if the Apgar test raises concerns, they should know that they are in the right place: surrounded by professionals with adequate training who will take care of and develop an appropriate treatment plan for them.
It is a method of evaluating the adaptation and vitality of the newborn after birth. This test, carried out all over the world, owes its name to Dr. Virginia Apgar, a famous American obstetric anesthetist, who in 1952 proposed this repeatable and straightforward method, seeking to quickly assess the situation of newborns and thus assess the effects, in them, from the anesthesia their mothers received.
What is the Apgar score?
The Apgar test assesses the baby’s heart rate, muscle tone, and other signs to determine if she needs additional or emergency medical help. Its application is standardized to evaluate the newborn at two moments after birth: at minute one after delivery and, again, five minutes after birth. Sometimes, if the baby’s physical condition is of concern, the baby can be evaluated a third time.
It is not a perfect test. The score will depend on the weeks of pregnancy, congenital malformations, medication administration to the mother, or complications in delivery.
Meaning of “Apgar”
In the word Apgar, each letter refers to the five evaluable items in the newborn: «Appearance, Pulse, Reflex Irritability (from English Grimace), Activity and Breathing. «
Each aspect is evaluated on a scale that goes from 0 to 2, with 2 being the highest possible score:
Appearance: refers to the color of the skin. Pulse: to heart rate. Reflex irritability: it is the response and gestures that the newborn makes to stimuli. Activity: assesses muscle tone. Breathing: the respiratory rate and effort are determined.
System of points
The gynecologists and midwives or nurses add the scores for these five factors to calculate the Apgar score. A baby’s score ranges from 0 to 10, where 10 is the highest possible score, but very few babies reach it. This is because many babies’ hands and feet remain blue until they warm up.
Each parameter is given a score of 0, 1, or 2; Then, they are all added together, obtaining a final value between 0 and 10. As one minute and five minutes of life are scored, two numbers are obtained; the first corresponds to the score at minute 1 of life and the second at minute 5. Example: 8/9 (an eight at one minute of life and a nine at 5 minutes after birth).
What is the Apgar test for?
The Apgar test allows a quick assessment of the clinical situation of the newborn to, if necessary, help him start breathing after delivery.
It is not a perfect test. The score will depend on the weeks of pregnancy, congenital malformations, administration of medication to the mother, or complications in childbirth.
What is the average score?
The average Apgar score is more than 7.
In the first minute of life, it is practically impossible to reach the maximum score because a good coloration of the newborn’s entire body is not achieved.
What if your child has a low Apgar test result?
The important thing is not the Apgar score but to know whether or not there have been problems at the time of delivery.
There is no clear relationship between a low Apgar test at 5 minutes of life and the psychomotor development of the newborn. Most children with cerebral palsy will have a regular Apgar test within 5 minutes. And on the contrary, many children with less than 3 in the Apgar test at 5 minutes will have normal development.
Interpret the Apgar score
A baby who scores seven or higher on the Apgar test is considered to have an excellent adaptation to extrauterine life after birth. But, getting a lower score does not mean that the baby is sick. All it means is that the baby needs some immediate medical treatment, such as suctioning his airways or giving him oxygen, to help him breathe. Some healthy babies have lower scores than usual, especially in the first minutes of life.
If the score is below 7, the baby needs help adjusting. Most of the time, stimulation, drying it, for example, is enough.
A somewhat lower score in the first minute is typical, especially in:
High-risk pregnancies. Cesarean section. A complicated delivery. Premature.
Most newborns improve their Apgar scores within five minutes. But if the baby’s score does not improve when the test is re-applied, the medical care that the newborn needs will continue to be applied, and the baby will be closely monitored.
Many babies with low Apgar scores are healthy and have no problem adjusting to extrauterine life. Remember that this test is not a predictor of the long-term health status of babies. The test was designed to help delivery professionals assess the physical condition to implement medical support measures if necessary quickly.