An indication of a newborn infant's overall medical condition.

The Apgar score is based on a series of assessments devised by pediatrician Virginia Apgar (1909-1974) in 1953, and is standard procedure in many delivery rooms. The primary purpose of the Apgar test is to determine as soon after birth as possible whether an infant requires medical intervention and possibly transfer to a neonatal intensive care unit. The test, which is administered one minute after birth and again four minutes later, evaluates the newborn's heart rate, breathing, muscle tone, color, and reflexes. Each category is given a score between 0 and 2, with the highest possible test score totaling 10. The infant's heart rate is assessed as either under or over 100 beats per minute. Respiration is evaluated according to regularity and strength of the newborn's cry. Muscle tone categories range from limp to active movement. Color—an indicator of blood supply—is determined byhow pink the infant is (completely blue or pale; pink body with blue extremities; or completely pink). Reflexes are measured by the baby's response to being poked and range from no response to vigorous cry, cough, or sneeze. An infant with an Apgar score of 8 to 10 is considered

Rating factor	Zero	1 point	2 points
Color	Blue or pale	Trunk pink, extremities blue	All pink
Heart rate	none	Under 100 beats per minute	Over 100 beats per minute
Muscle tone	Limp	Some movement of limbs	Active movement of limbs
Reflex irritability	No response	Grimace when "poked" in the nose	Cry, cough, or sneeze when "poked" in the nose
Respiratory effort	None	Irregular, with weak cry	Regular, with strong cry

to be in excellent health. A score of 5 to 7 shows mild problems, while a total below 5 indicates that medical intervention is needed immediately.

For Further Study

Books

Apgar, V., and J. Beck. Is My Baby Alright? New York: Trident Press, 1972.

McCullough, Virginia. Testing and Your Child: What You Should Know About 150 of the Most Common Medical, Educational, and Psychological Tests. New York: Plume, 1992.

Uzgiris, Ina C, and J. McVicker Hunt. eds., Infant Performance and Experience: New Findings with the Ordinal Scales. Urbana, IL: University of Illinois Press, 1987.