Committee Opinion No. 644: The Apgar Score

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(Obstet Gynecol. 2015;126:e52–e55)

The purpose of this statement was to address limitations of the Apgar score and place it into its proper perspective. Created by Dr Virginia Apgar in 1952, the Apgar score is a standardized scoring system that assesses the clinical status and physiological condition of a newborn immediately after birth. It is meant to address clinical signs of neonatal depression and consists of 5 components (color, heart rate, reflexes, muscle tone, and respiration). Each component is assigned a score of 0, 1, or 2, assessed at 1- and 5-minutes after delivery. In 2014, the American College of Obstetricians and Gynecologists, in collaboration with the American Academy of Pediatrics, published the Second Edition of Neonatal Encephalopathy and Neurologic Outcome, which defines a 5-minutes Apgar score of 7 to 10 as reassuring, 4 to 6 as moderately abnormal, and 0 to 3 as low in the term infant and late-preterm infant; very few infants with a score of 0 beyond 10 minutes of age have been reported to survive with normal neurological outcome.

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