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APGAR Score

Rapid assessment of neonatal well-being at 1 and 5 minutes after birth. Five components scored 0–2 each for a total of 0–10.

Inputs

Appearance (skin color)

Pulse (heart rate)

Grimace (reflex irritability)

Activity (muscle tone)

Respiration

APGAR Score (0–10)

Severely depressed

Interpretation—

Action—

Disclaimer: For educational purposes only. The APGAR score does not guide resuscitation decisions — initiate NRP (Neonatal Resuscitation Program) steps based on clinical assessment, not score.

Scoring

Appearance (skin color): 0–2
Pulse (heart rate): 0–2
Grimace (reflex irritability): 0–2
Activity (muscle tone): 0–2
Respiration: 0–2

Interpretation

7–10: Reassuring — routine newborn care
4–6: Moderately depressed — may need stimulation/airway management
0–3: Severely depressed — immediate resuscitation needed

Clinical pearls

Score at 1 minute reflects immediate condition; 5 minutes assesses response to resuscitation.
If 5-minute score < 7, reassess every 5 minutes up to 20 minutes.
APGAR does not predict long-term neurologic outcome and should not be used in isolation.
Preterm infants may have lower baseline scores; interpret in context of gestational age.
Do not delay resuscitation to calculate the APGAR score.

References

Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32(4):260–267.
AAP/AHA. Neonatal Resuscitation Program (NRP), 8th edition, 2021.