APGAR Score
Standardised assessment of newborn condition at 1 and 5 minutes after birth. Five parameters scored 0–2. Score ≥7 = good condition; 4–6 = moderate concern; ≤3 = requires immediate resuscitation. Does NOT predict long-term neurological outcome.
How to use & interpret
The Apgar score is a rapid assessment of a newborn's condition, recorded at 1 and 5 minutes (and every 5 minutes thereafter if low). Five components — Appearance (colour), Pulse, Grimace (reflex irritability), Activity (tone) and Respiration — each score 0–2, for a total of 0–10.
Broadly, 7–10 is reassuring, 4–6 is moderately abnormal, and 0–3 is low and prompts active resuscitation. The Apgar guides immediate care and the response to resuscitation; it is not designed to predict long-term neurological outcome, and resuscitation should never be delayed to assign a score.
Score interpretation
APGAR 7–10 — normal; good neonatal adaptation
→ Routine newborn care; dry and warm; initiate skin-to-skin contact and breastfeeding; reassess at 5 minutes; document scores clearly
APGAR 4–6 — moderate; requires stimulation and oxygen support
→ Stimulate (rub back, flick feet); provide supplemental oxygen; reassess at 5 minutes; have resuscitation team available; if not improving, escalate to full neonatal resuscitation; NICU consult
APGAR 0–3 — severely depressed; requires immediate intervention
→ Initiate neonatal resuscitation immediately (NLS protocol): airway positioning, bag-mask ventilation, chest compressions if HR <60; call NICU/neonatal team; IV/IO adrenaline if no response; consider cord gas, metabolic screen, therapeutic hypothermia if eligible
Interpretation bands for the APGAR Score. Apply clinical judgement and local guidance.
Frequently asked questions
Does a low Apgar score predict cerebral palsy?
A single low score does not. Only persistently very low scores combined with other findings (cord gases, encephalopathy) carry prognostic weight; Apgar alone should not be used to predict long-term outcome.
References
- Apgar V. A proposal for a new method of evaluation of the newborn infant. Anesth Analg. 1953;32(4):260–267.
Related
Curated clinical cross-links plus same-class fallbacks.
- Lipid Emulsion 20% (Intralipid) · Antidote / Resuscitation
- Lipid Emulsion 20% (Intralipid) · Antidote / Resuscitation
- Rozanolixizumab · Neonatal Fc receptor (FcRn) antagonist
- Efgartigimod alfa · Neonatal Fc receptor (FcRn) blocker
- Hydroxyprogesterone Caproate / Progesterone (Preterm Birth Prevention) · Progestogen (Preterm Birth Prevention)
- Phenobarbital (Paediatric Epilepsy — Beyond Neonatal) · Barbiturate Anticonvulsant
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.