The Apgar score was devised in 1952 by Dr. Virginia Apgar as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after birth. This test was designed to evaluate a newborn's physical condition after delivery and to determine any immediate need for medical or emergency care. The scoring is performed at 1 minute and 5 minutes after birth. If the fetus is compromised, the score may be repeated at 10 and 20 minutes.

The acronym APGAR stands for:

• A: Appearance (Skin color)
• P: Pulse (Heart rate)
• G: Grimace (Reflex irritability)
• A: Activity (Muscle tone)
• R: Respiration(Respiratory effort)

These five factors are scored on a scale of 0-2, with 2 being the best score. The resulting Apgar score ranges from 0-10. The total score is calculated by adding the score for all the five components.

Interpretation of Apgar Score:

• 7-10 = Normal
• 4-6 = Might need resuscitation
• <= 3 = Needs immediate resuscitation

In most situations, a low Apgar score at one minute progresses to a normal score by 5 minutes. A score that remains low at 5 minutes is a major concern and usually requires intervention.

Reference:

1. Patel D, Piotrowski ZH, Nelson MR, et al. Effect of a statewide neonatal resuscitation program on apgar scores among high risk neonates in illinois. Pediatrics. 2001;107(4):648-55.
2. American Academy of Pediatrics, Committee on Fetus and Newborn, American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. The Apgar Score. Pediatrics 2006;117;1444.