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APGAR Score
Neonatal assessment at 1 and 5 minutes — evaluates five signs of newborn condition
Pediatrics
⚕️
Clinical reference only. Not a substitute for professional medical judgment. Verify all results against institutional protocols before clinical use.
Calculate
APGAR score guides immediate resuscitation but does not predict long-term neurological outcome. 5-minute score carries more prognostic weight.
Formula
APGAR = Appearance + Pulse + Grimace + Activity + Respiration (each 0–2)
AAppearance (skin color): 0=blue/pale, 1=body pink/extremities blue, 2=fully pink
PPulse (heart rate): 0=absent, 1=<100 bpm, 2=≥100 bpm
GGrimace (reflex irritability): 0=none, 1=grimace, 2=cry/cough/sneeze
AActivity (muscle tone): 0=limp, 1=some flexion, 2=active motion
RRespiration: 0=absent, 1=weak/irregular, 2=strong cry
When to Use
Every delivery room — assessed at 1 and 5 minutes of life. Guides immediate resuscitation decisions in the delivery room.
Clinical Pearls
- •5-minute APGAR is more prognostically significant than 1-minute APGAR.
- •APGAR <7 at 5 minutes: reassess every 5 minutes up to 20 minutes per NRP guidelines.
- •Prematurity, maternal sedation, and congenital anomalies can lower APGAR independent of asphyxia.
- •APGAR was not designed as a measure of asphyxia — persistent pH <7.0 and base deficit >12 are better indicators.
Original Publication
Apgar V (1953). Curr Res Anesth Analg.