Apgar Newborn Score (1 & 5 minutes)

Rapid standardized assessment of newborn viability and response to resuscitation, scored at 1 and 5 minutes across five signs (0–2 each).

Apgar = Appearance (colour) + Pulse (HR) + Grimace (reflex irritability) + Activity (muscle tone) + Respiration — each 0–2, total 0–10 Score 7–10 reassuring · 4–6 moderately depressed (stimulate, O₂) · 0–3 critically low (immediate resuscitation) Rate at 1 min and 5 min; a 5-min score ≤3 is a strong predictor of neonatal mortality.

Published Clinical Benchmark Cases

Clinical Parameters & Inputs

Appearance (skin colour)

Pulse (heart rate)

Grimace (reflex irritability)

Activity (muscle tone)

Respiration (respiratory effort)

Computed OutputModerately Depressed (Apgar 5)

5/ 10

Diagnostic Interpretation

Apgar is 5/10 — moderately depressed. Stimulate, dry, provide supplemental O₂ and airway support; reassess at 1-minute intervals.

Calculation Breakdown

Component Sum

Appearance 1 + Pulse 1 + Grimace 1 + Activity 1 + Respiration 1 =Apgar 5 / 10

Clinical Decision Pearls

Resuscitation is guided by HR and respiration, NOT the 1-minute Apgar — never wait for the score to start.
Record scores at 1 and 5 minutes; extend to 10/15/20 minutes while the score is rising.

Limitations & Confounders

Apgar is a descriptor of transition, not a diagnostic of asphyxia and should not alone define hypoxic-ischemic injury.
Scores are affected by prematurity, maternal sedation, and congenital anomalies.

Evidence & Citations

Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953;32(4):260-267.