Apgar score for newborns
In the medical record of each baby who was born in the hospital, Apgar scores are indicated. What does the result mean, is there a norm for newborns and how to decipher the assessment – says the pediatrician

In and foreign maternity hospitals, the Apgar scale is used. This assessment appeared in the middle of the last century. But the professional community believes that, despite progress and high technology, nothing better has been created for the clinical assessment of the child’s condition (1). US anesthesiologist Virginia Apgar figured out how to objectively assess the condition of a newborn in the first minutes of life. The system was adopted. Since then, Apgar scores have been entered into the medical record. Let’s figure out what the result means, how to decipher it and whether there is a norm in the Apgar scale for newborns.

Deciphering Apgar scores

The newborn is assessed on the Apgar scale by a neonatologist. This is a specialist who deals with the treatment and prevention of a number of pathologies in newborns.

During the examination, the neonatologist looks for five signs:

  • heart rate;
  • breath;
  • muscle tone;
  • reflexes;
  • color of the skin.

Each is assigned a score from 0 to 2. In total, an infant can score a total of 10 points.

  • A score of 2 points in the delivery room is considered the highest and means that the symptom is pronounced.
  • 1 point – weakly expressed
  • 0 points – the feature is absent.

Evaluate the child on the Apgar scale at the first and fifth minutes of life. Therefore, there are always two scores. For example 8/9 points or 9/10 points.

Apgar scoretranscript
from 0 to 3Correspond to either cardiac and respiratory arrest, or a state of severe bradycardia (cardiac arrhythmia), hypoventilation (poor ventilation of the lungs), or depression of the central nervous system. In most cases, low scores are associated with difficulty in initiating spontaneous breathing, and not with primary cardiac pathology. Most infants with severe asphyxia also develop fetal acidosis (blood pH
from 4 to 7The newborn requires a closer examination to see if the condition can improve. You need to make sure that the infant does not have any pathological conditions that contribute to such low scores.
from 8 to 10Healthy term infants with normal cardiopulmonary adaptation.

Apgar norm

– Children rarely gain the maximum 10 points in the first minute of life. Usually, the first score is always lower than the second. But the second one can just be equal to 10 points, – explains Yegor Gavryushkin, a pediatrician, consultant of the digital medical service Doctor Nearby.

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The expert notes an important nuance that may affect the rate on the Apgar scale. Until recently, anesthesia during childbirth was not used. Therefore, if the baby did not scream after birth, the doctor understood that he had asphyxia (suffocation during oxygen starvation) and urgent help was needed.

– Now this sign is not indicative. The fact that the baby is silent at first does not necessarily mean that the child is in trouble. Perhaps this is the effect of anesthesia, the pediatrician explained.

Popular questions and answers

What is the Apgar score for?

– Dr. Virginia Apgar proved that with such an assessment it is possible to predict the need for resuscitation. The medical community has recognized that her method is accurate, objective and easy enough to use in daily practice. Timely therapy based on the use of the scale has improved infant survival rates,” says pediatrician Egor Gavryushkin.

Is it true that a low Apgar score means that a child will grow up sick?

– Not. In most cases, low scores are associated with difficulty in initiating spontaneous breathing, and not with primary cardiac pathology. But at the same time, children who have a primary pathology will also have low Apgar scores. The scale is a method for determining the need for resuscitation. It does not allow us to provide a prediction about the child’s future health. This is not her goal. As well as a result of 10 points does not guarantee that the baby will grow up healthy, the expert comments.

At the same time, scientists studied whether the Apgar score affects health as early as adolescence (14-18 years). It turned out that the “multi-balloons” less often develop pathologies of the central nervous, cardiovascular systems, and skin. (2) However, the percentage is not so large as to declare it a pattern.

Studies were conducted that correlated the IQ level of older children, predisposition to neurological and mental disorders, and the risk of developing attention-deficit/hyperactivity disorder (ADHD) from Ohm’s syndrome with Apgar scores. In short, there is a correlation, but also insignificant. (3)

Is it appropriate to use the technique for premature babies

– The Apgar scale does not provide an objective assessment of the condition of premature babies. The skin of a premature baby is bright pink, he screams, moves actively and deserves a high rating on the scale. But doctors know that after 15-20 minutes the baby’s health will begin to deteriorate. It is possible that in half an hour he will need to be connected to a ventilator.

Sources of

  1. Kirilochev O.K. The Apgar scale is 60 years old / Bulletin of Perinatology and Pediatrics No. 2, 2012. URL: https://cyberleninka.ru/article/n/shkale-apgar-60-let/viewer
  2. Belyaeva L. E., Pendo L. V., Ligetskaya I. V., Smirnova O. I. Analysis of the health status of children aged 14-18 years who received different Apgar scores at the 5th minute after birth / Bulletin of VSMU Volume 12 , No. 1, 2013 URL: https://elib.vsmu.by/bitstream/123/6189/1/vVGMU_2013_1_77-82.pdf
  3. Natalie Grizenko, Maria Loren Eberle, Gabriel Côté-Corriveau, Claude Jolicoeur, Ridha Joober Apgar Scores Are Associated with Attention-Deficit/Hyperactivity Disorder Symptom Severity / The Canadian Journal of Psychiatry №61(5) 2016, страницы 283–290. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841284/

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