APGAR Score

Assesses the health of a newborn immediately after birth.

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Parameters

Appearance (Skin Color)*

Blue or pale all over

Acrocyanosis (blue extremities, pink body)

Pink all over

Pulse (Heart Rate)*

Absent

< 100 bpm

> 100 bpm

Grimace (Reflex Irritability)*

No response to stimulation

Grimace or feeble cry when stimulated

Cry or active withdrawal to stimulation

Activity (Muscle Tone)*

Limp, flaccid

Some flexion of arms and legs

Active motion

Respiration (Breathing Effort)*

Absent

Weak, irregular, or gasping

Good, strong cry

APGAR Score Result

FormulaSum of points from 5 categories: Appearance, Pulse, Grimace, Activity, Respiration (each scored 0-2).

Clinical Pearls

Routinely evaluated at 1 and 5 minutes after birth. A 5-minute score of <7 prompts reassessment every 5 minutes up to 20 minutes.

Limitations

The score is subjective and can be influenced by maternal medications, prematurity, or congenital anomalies. It is not designed to predict long-term neurological outcomes.

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