Your Child’s First Test: The APGAR

What is the APGAR test?

The APGAR is a quick, overall assessment of newborn well-being. The test is used immediately following the delivery of a baby. APGAR scores are recorded at one minute and five minutes from the time of birth.

Why is it necessary?

The one minute APGAR assessment provides information about the baby’s physical health and helps the physician determine if an immediate or future medical treatment will be required. The five-minute assessment measures how the baby has responded to previous resuscitation attempts if such attempts were made.

What conditions does the APGAR test evaluate?

APGAR measures the baby’s color, heart rate, reflexes, muscle tone, and respiratory effort.

What do the APGAR scores mean?

APGAR scores range from zero to two for each condition with a maximum final total score of ten. At the one minute APGAR, scores between seven and ten indicate that the baby will need only routine post-delivery care.  Scores between four and six indicate that some assistance for breathing might be required. Scores under four can call for prompt, lifesaving measures.
At the five minute APGAR, a score of seven to ten is normal. If the score falls below seven, the baby will continue to be monitored and retested every five minutes for up to twenty minutes. Lower than normal scores do not mean that there will be permanent health problems with the child.
Heart rate:
0 – No heart rate
1 – Fewer than 100 beats per minute indicates that the baby is not very responsive.
2 – More than 100 beats per minute indicates that the baby is vigorous.
0 – Not breathing
1 – Weak cry–may sound like whimpering or grunting
2 – Good, strong cry
Muscle tone:
0 – Limp
1 – Some flexing (bending) of arms and legs
2 – Active motion
Reflex response:
0 – No response to airways being stimulated
1 – Grimace during stimulation
2 – Grimace and cough or sneeze during stimulation
0 – The baby’s entire body is blue or pale
1 – Good color in body but with blue hands or feet
2 – Completely pink or good color

Want to Know More?

Compiled using information from the following sources:

Nemours Foundation,

William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 28.