What does the Apgar score assess?
The Apgar score is a scoring system developed by the American anesthesiologist V. Apgar in 1952 to test the vitality of newborns. It includes the following parameters:
- Appearance (skin color)
- Pulse (heart rate)
- Basal tone (muscle tone)
- Respiration
- Reflexes
Scoring of the Apgar score
Skin Color
- 0 points: pale, blue skin color
- 1 point: rosy body, blue extremities
- 2 points: rosy skin on the whole body
Pulse
- 0 points: no heartbeat
- 1 point: less than 100 beats per minute
- 2 points: over 100 beats per minute
Muscle tone
- 0 points: slack muscle tone, no movements
- 1 point: light muscle tone
- 2 points: active movements
- 0 points: no breathing
- 1 point: slow or irregular breathing
- 2 points: regular breathing, vigorous crying
Reflexes
- 0 points: no reflexes
- 2 points: good reflexes (child sneezes, coughs, screams)
When is the Apgar score measured?
The Apgar score is determined three times. The first assessment is done one minute after birth. Then all parameters are assessed again after five minutes as well as after ten minutes. The Apgar scores after five and ten minutes are more significant for prognosis than the first value after one minute. These values enable the physician or obstetrician to assess the effect of supportive measures in particular.
A newborn baby with an Apgar score between eight and ten points is doing well (life-fresh child). As a rule, the newborn does not then need any support.
If the Apgar score is between five and seven, there is no cause for concern. A little oxygen or gentle massage is usually enough to compensate for minor adjustment difficulties.
What is an adjustment disorder?
If a child has difficulty adjusting to life outside the womb after birth, experts speak of an adjustment disorder (also called a depressive state). This can be severe or mild. An adjustment disorder begins with an Apgar score of less than seven points (moderate depression) and is manifested by the following symptoms:
- delayed onset of breathing
- slowed heartbeat (bradycardia)
- Low muscle tone
- absent or weak reflexes
A newborn with symptoms of an adjustment disorder is gently stimulated after initial care. The measures depend on how severe the adjustment disorder is. If the adaptation disorder is mild, it is usually sufficient to give the infant some oxygen. This may need to be administered via a breathing mask.
Only a few newborns (about five percent) have serious problems with the transition after birth. It is not possible to predict the child’s later development on the basis of the Apgar score. Ultimately, the score helps to determine the baby’s viability immediately after birth and to check the effectiveness of supportive measures.
