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Apgar Scale: Assessed Signs, Chart, and Scores

apgar scale in newborns

The Apgar scale has been a fundamental tool in the field of obstetrics and neonatology for over six decades, and it plays a crucial role at the moment of birth. Learn more about it in this article!

Do you have a newborn baby? Then you might have noticed the importance of the Apgar scale in assessing your child’s first minutes of life. This tool, with its objective scoring, provides an instant view of the baby’s physiological state, allowing for prompt medical intervention if necessary.

The Apgar scale is a reliable way to check if a baby is breathing well, has a stable heart rate, demonstrates adequate muscle tone, and has healthy skin coloration. This initial assessment is crucial to ensure that newborns receive the proper care and can begin their life journey safely and with the best care possible.

Keep reading to learn in detail what the Apgar scale is, what it is used for, how the test is conducted, and how to interpret the Apgar score.

What is the purpose of the Apgar scale?

The Apgar scale, developed in 1952 by anesthesiologist Virginia Apgar, is a quick and objective assessment of the newborn’s physiological state in the first few minutes of life. The purpose of the Apgar scale is to evaluate the baby’s adaptation to life outside the womb and, if necessary, take immediate measures to improve their condition.

How is the assessment done?

The Apgar scale assesses five vital signs of the newborn:

  • Heart rate
  • Respiration
  • Muscle tone
  • Reflex irritability
  • Skin color

Each sign is evaluated on a scale of 0 to 2, with a maximum score of 10. The examination is performed immediately after birth – one minute after birth to be exact, and then again five minutes after birth.

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In cases where newborns require special care, the assessment may be repeated at intervals of 5 to 10 minutes.

Apgar Scale Chart

The Apgar scale chart consists of five vital signs of the newborn and the corresponding Apgar score for each of them:

Heart rate

  • 0 points: Absent heart rate
  • 1 point: Less than 100 beats per minute
  • 2 points: More than 100 beats per minute


  • 0 points: Absent breathing
  • 1 point: Irregular or weak breathing
  • 2 points: Strong crying and regular breathing

Muscle tone

  • 0 points: Absent movements
  • 1 point: Flexion of arms and legs
  • 2 points: Active movements

Reflex response to stimulation

  • 0 points: No response to stimuli
  • 1 point: Grimacing or sneezing in response to stimuli
  • 2 points: Strong crying in response to stimuli

Skin color

  • 0 points: Pale or bluish
  • 1 point: Pink body with bluish extremities
  • 2 points: Pink color all over the body

What does the Apgar score mean?

The Apgar scale result has a scoring range of 0 to 10. Newborns with an Apgar score between 7 and 10 are considered healthy and do not require special care. Apgar scores between 4 and 6 indicate that the newborn needs attention and, depending on the cause of the low score, they may require immediate medical interventions.

Apgar scores below 4 indicate a severe condition and require quick action and intensive measures to stabilize the baby.

It is important to note that the Apgar scale is only an initial assessment tool and should not be used as a definitive diagnosis of any newborn’s health condition.

What happens if the baby scores less than 7?

If a newborn has an Apgar score below 7 on the Apgar scale, it is important for the medical team to take immediate measures to improve their condition. Depending on the cause of the low score, these measures may include interventions to improve breathing, administration of medication to stabilize heart rate, massage to improve muscle tone, and even warming the baby to maintain the appropriate body temperature.

In more severe cases, the baby may require more intensive interventions, such as mechanical ventilation, use of medications to increase blood pressure, or even surgery. It is crucial for healthcare professionals to be trained and equipped to handle these situations and ensure the best possible care for the newborn.

Now that you know what the Apgar scale is for and how it works, take the opportunity to download the Kinedu app for FREE and closely monitor your baby’s development!

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