From the Guidelines
Apgar scores are typically taken at 1 and 5 minutes after birth, with additional scores taken every 5 minutes for up to 20 minutes if the 5-minute score is below 7. The Apgar score is a quick assessment of a newborn's physical condition based on five criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color [ 1 ]. Each criterion is scored from 0 to 2, with the total score ranging from 0 to 10. The one-minute score determines how well the baby tolerated the birthing process, while the five-minute score indicates how well the baby is adapting to the environment outside the womb.
Key Points to Consider
- A 1-minute Apgar score of 0 to 3 does not predict any individual infant’s outcome [ 2 ].
- A 5-minute Apgar score of 0 to 3 correlates with neonatal mortality in large populations but does not predict individual future neurologic dysfunction [ 3 ].
- If the five-minute score is below 7, additional scores may be taken every 5 minutes for up to 20 minutes [ 1 ].
- The Apgar score is affected by many factors, including gestational age, maternal medications, and neurologic conditions [ 2 ].
Clinical Implications
The Apgar score is an essential tool for healthcare providers to quickly assess a newborn's physical condition and identify potential issues that may require immediate medical attention [ 1 ]. However, it is crucial to note that Apgar scores are not designed to predict long-term health outcomes [ 3 ]. By understanding the limitations and applications of the Apgar score, healthcare providers can use this tool effectively to provide optimal care for newborns.
From the Research
Apgar Score Frequency
- Apgar scores are typically taken at 1, 5, and 10 minutes after birth 4, 5, 6, 7
- The frequency of Apgar score assessments may vary depending on the clinical condition of the newborn and the hospital's protocols
- Some studies have reported Apgar scores at additional time points, such as 3 hours after birth 8
Clinical Significance of Apgar Scores
- Apgar scores are used to assess the overall health and well-being of newborn infants, particularly in the first few minutes after birth 4, 5, 6, 7
- Low Apgar scores have been associated with increased risk of mortality, hypoxic-ischemic encephalopathy, and other adverse outcomes 4, 8
- Apgar scores can be used to identify infants who may require additional medical attention or intervention, such as respiratory support or oxygen therapy 8, 5, 6, 7
Resuscitation Strategies and Apgar Scores
- The use of room air versus 100% oxygen for resuscitation has been studied in relation to Apgar scores, with some studies suggesting that room air may be associated with faster improvement in Apgar scores 5, 6, 7
- The optimal oxygen concentration for resuscitation is still a topic of debate, and further research is needed to determine the best approach for improving Apgar scores and outcomes in newborn infants 5, 6, 7