Feature | What Is The Apgar Score Test And What Does It Mean?

What Is The Apgar Score Test And What Does It Mean?

Have you heard of the Apgar score? Learn all about it and what it means for you and your new baby here!

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In this article:

  1. Apgar Score Definition: What Is the Apgar Score?
  2. Who Needs to Take the Apgar Test?
  3. When Do Doctors Perform the Apgar Test?
  4. Where Is the Apgar Test Performed?
  5. How Do Doctors Perform the Apgar Test?
  6. What Do the Apgar Scores Mean?
  7. Why Is the Apgar Score Important?

Everything You Need to Know About the Apgar Score

Apgar Score Definition: What Is the Apgar Score?


Dr. Virginia Apgar developed the Apgar scale and introduced it in 1952. The Apgar score is a quick test that determines a newborn’s overall clinical status at birth.

Apgar is actually an acronym that represents the five components of the test measures, namely:

  • Appearance – refers to the baby’s skin color
  • Pulse – refers to the baby’s heart rate
  • Grimace Response – refers to the baby’s irritability reflex
  • Activity – refers to the baby’s muscle tone
  • Respiration -refers to the baby’s breathing rate

The resulting score from the test can help determine if newborns need any extra medical attention. The Apgar test is widely accepted and is a part of the newborn screening procedures of most modern hospitals.

Who Needs to Take the Apgar Test?

Doctors, midwives, or nurses should administer the Apgar test to all newborn babies, and it is especially important for babies who were born prematurely, delivered via cesarian section, experienced a complicated delivery, or who are products of a high-risk pregnancy.

When Do Doctors Perform the Apgar Test?

The Apgar test is normally performed twice: one minute after birth and then again at five minutes after birth. Health professionals routinely administer the test twice because newborns have the tendency to score low during the one-minute mark and improve by the five-minute re-take.

Health professionals generate the Apgar score immediately so they can give proper medical intervention if needed. In some high-risk cases, doctors will continue to administer the Apgar test 10 minutes after birth, 15 minutes after birth, and finally 20 minutes after birth.

Where Is the Apgar Test Performed?

Where Is the Apagar Test Performed? | What is the Apgar Score Test And What Does It Mean?

Doctors, nurses, or midwives will usually perform the test and generate the Apgar score in the delivery room or in a nearby examination room. They need an area where they can lay the baby down and clean the baby before they perform the quick test.

Most new moms don’t even notice that the test is being performed because it happens very quickly and so soon after the delivery. If you hear your newborn baby crying as you catch your breath in the delivery room, that’s probably your doctor administering the Apgar score test.

RELATED: Importance Of The Newborn Screening Test | Newborn Screening Awareness Month

How Do Doctors Perform the Apgar Test?

Health professionals examine the five Apgar components to generate the Apgar score:

  • Appearance – The health professional will observe the newborn’s skin tone and take note of any bluish discoloration. Non-caucasian babies sometimes appear ashen, so doctors will also examine the color of their lips, tongue, and mouth.
  • Pulse – The health professional will listen to the baby’s heart using a stethoscope, and they will take note of their heart rate.
  • Grimace Response – The health professional will gently tap on the sole of the infant’s foot and observe the baby’s reaction.
  • Activity – The health professional will extend the infants arms and take note of the amount of flexion exhibited by the baby.
  • Respiration – The health professional will observe the baby’s breathing, cry, and chest auscultation.

What is chest auscultation? Auscultation is another term for a doctor listening to the body’s sounds through a stethoscope. With chest auscultation, that means a doctor listens to the heartbeat of a baby.

The health professional assigns a score of 2, 1, or 0 for each component. They use this Apgar score chart:


  • 2 – infant’s whole body is pink
  • 1 – infant’s body is pink, but the extremities (hands and feet) are bluish
  • 0 – infant’s whole body is pale or bluish-gray


  • 2 – infant’s heart rate is normal (more than 100 beats/minute)
  • 1 – infant’s heart rate is under 100 beats/minute
  • 0 – infant has no heartbeat

Grimace Response:

  • 2 – infant pulls away, grimaces, coughs, sneezes, or vigorously cries
  • 1 – infant exhibits facial movement only (such as a grimace)
  • 0 – infant did not exhibit a reaction


  • 2 – infant exhibits active, spontaneous motion
  • 1 – infant exhibits little movement with flexed arms and legs
  • 0 – infant exhibits no movement and muscles are loose and floppy


  • 2 – infant is breathing at a normal rate and effort. Exhibits a good cry
  • 1 – infant’s breathing is slow or irregular. Exhibits a weak cry
  • 0 – infant is not breathing

The health professional adds up the scores from each component to generate the Apgar score.

What Do the Apgar Scores Mean?

An infant can receive an Apgar score between 0 and 10. Here are what the Apgar scores mean:

  • 7 to 10 – The infant has adapted well and can proceed with regular post-natal care without any specific intervention.
  • 4 to 6 – The infant will require some medical intervention. This can come in the form of suctioning the airways or administering an oxygen mask to help the infant breathe better.
  • 3 or below – The infant needs serious medical intervention or lifesaving measures such as resuscitation.

Getting a perfect score of 10 is very rare since it’s normal for most infants to have blueish extremities when they are born. Keep in mind that the Apgar score is only indicative of how well your baby is adapting to the new environment.

That’s why the test is usually administered twice because some newborns need a little time to adjust. The Apgar score does not predict other outcomes such as your baby’s long-term health, intelligence, personality, or behavior.

Why Is the Apgar Score Important?

Before the Apgar test was introduced, doctors didn’t really pay much attention to babies when they were born. Doctors and nurses tended to the new mom, while the babies were simply cleaned and brought to the nursery.

Unfortunately, it’s sometimes difficult to detect if a newborn baby has respiratory or circulatory problems. The Apgar score test is a simple and systematic way to determine if a newborn baby needs any kind of medical intervention.


Check out this video from Medzcool to see how to calculate an APGAR score:

YouTube video

The Apgar score test has helped ensure countless babies’ safe transition from the womb to the world. But try not to worry too much about the score, especially if your doctor hasn’t given you any reason to.

Many studies show the Apgar score is not linked to any long-term developmental outcome. If your doctor isn’t showing any concern over your baby’s Apgar score, neither should you.

So put that number aside and bask in your new bundle of joy.

What have you been doing to prepare for your little one’s arrival? Let us know in the comments section!

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