Apgar score

Dr Henry Knipe and A.Prof Frank Gaillard et al.

Apgar score was originally described by Virginia Apgar (American anaesthesiologist, 1909-1974) in 1952.

Helpfully, her surname is also a useful mnemonic for remembering the 5 factors: each is graded as 0, 1 or 2 with a total possible score of 10. The lower the score the worse the prognosis.

The test is performed immediately after birth and then at 5 minutes. A low score initially may simply indicate the the neonate requires medical attention, whereas the latter at 5 minutes is associated with a poor prognosis.

Appearance (skin colour):

  • 0: central cyanosis
  • 1: peripheral cyanosis (acrocyanosis)
  • 2: no cyanosis


  • 0: absent
  • 1: <100
  • 2: >100


  • 0: no response to stimulation
  • 1: grimace/feeble cry when stimulated
  • 2: sneeze/cough/pulls away when stimulated

Activity (muscle tone):

  • 0: none
  • 1: some flexion
  • 2: active movement


  • 0: absent
  • 1: weak or irregular
  • 2: strong
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