Overview: The Apgar scoring system is used to assess newborn infants for depression of
cardiopulmonary and neurological function. Scoring is done at 1 and 5 minutes after birth.
Parameter Finding Points
color blue pale 0
body pink extremities blue 1
all pink 2
heart rate absent 0
< 100 1
> 100 (will use >= 100) 2
respiration absent 0
irregular slow 1
good crying 2
reflex response to nose catheter
sneeze cough 2
muslce tone limp 0
some flexion of extremities 1
Apgar score = SUM(points for all 5 parameters)
• minimum score: 0
• maximum score: 10
• The lower the score the more profoundly affected the infant is with scores under 5
• A low initial scores with no improvement in the 5 minute score is associated with neonatal
problems including death.
Apgar V. A proposal for a new method of evaluation of the newborn infant. Anesth Analg.
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Berkow R Fletcher AJ et al. The Merck Manual of Diagnosis and Therapy 16 edition. 1992.
Graef JW. Manual of Pediatric Therapeutics 5 edition. Little Brown and Co. 1994.
Nelson WE Behrman RE et al (editors). Nelson Textbook of Pediatrics 15 Edition. WB
Saunders Company. 1996. Chapter 79: The newborn infant pages 433-440. Table 79-2 page
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