What Are the Criteria for APGAR Scores?
An APGAR score is a numerical value assigned to newborn infants to assess their health immediately after birth. It was invented in 1952 by Dr. Virginia Apgar.
APGAR scoring evaluates five vital signs of newborns after birth, each with a possible score of 0, 1, or 2. The highest score a child can receive is 10, and the lowest is 0.
The following criteria are measured when assessing an APGAR score:
- Appearance: Skin color
- 0 is pale blue, 1 is pink body and blue extremities, 2 is completely pink
- Pulse: Heart rate
- 0 is absent, 1 is slower than 100 beats per minute, 2 is above 100 beats per minute
- Grimace: Reflexes in response to stimulation
- 0 is none, 1 is a grimace, 2 is a vigorous cry
- Activity: Muscle tone
- 0 is flaccid, 1 is some flexion of extremities, 2 is active motion
- Respiration: Breathing rate and effort
- 0 is absent, 1 is slow, 2 is crying
In most cases, APGAR scores are recorded at one and five minutes after delivery. However, expanded recording may be used at five-minute intervals for up to 20 minutes for infants who score below 7 at the five-minute mark and for those requiring resuscitation. Breathing and heart rate are the two most important factors in ensuring oxygenated blood is delivered to the baby’s brain.
What is Considered a ‘Normal’ APGAR Score?
An APGAR score of 7 through 10 is within the “normal” range and is typically reassuring to doctors and parents. A score between 4 and 6 is considered “moderately abnormal,” and health care professionals should reassess the newborn every five minutes for up to 20 minutes. An APGAR score of 0 through 3 is considered low and indicates that the newborn likely needs medical attention and has potentially experienced hypoxia—or low levels of oxygen—during labor and delivery.
APGAR scoring is widely used as an initial check on newborns’ immediate health status. However, the APGAR score should not be interpreted in isolation but as part of a broader medical assessment. The score is limited because it provides subjective information on an infant’s physiology at a point in time and should not be interpreted alone as evidence of—or lack of—conditions like asphyxia, or oxygen deprivation. Nevertheless, a low APGAR score is certainly consistent with hypoxia.
Could a Low APGAR Score Indicate a Potential Birth Injury?
Sometimes, a low APGAR score could indicate that the newborn experienced hypoxia during delivery. Importantly, APGAR scores are not used alone to diagnose birth injuries or predict long-term health outcomes. A full medical assessment is necessary for diagnostic purposes. However, the scores might correlate to a birth injury. Thus, various potential birth injuries could be associated with a low APGAR score, including the following:
- Cerebral palsy
- Neurological conditions
- Hypoxic-ischemic encephalopathy, or HIE
- Stroke
- Umbilical cord injuries
- Perinatal asphyxia
- Infections
Research suggests that a low 5-minute APGAR score may be associated with an increased relative risk of cerebral palsy–anywhere from 20 times to 100 times higher than those with a 5-minute score of 7-10. The risk of poor neurologic outcomes increases when the score is 3 or less at 10, 15, and 20 minutes. It is also important to understand that your baby receives oxygen through the umbilical cord during labor. Medical intervention must be undertaken if the baby is not getting enough oxygen.
Contacting a Medical Malpractice Attorney
The APGAR score, as part of the infant’s medical record, is one of many factors that may be reviewed when investigating a birth injury. However, a low score alone is not sufficient to establish a claim. The burden of proof is on the plaintiff to show that health care providers departed from the prevailing professional standard of care under the circumstances. An experienced medical malpractice attorney can investigate and gather the evidence necessary to meet this burden of proof. If you believe your child has suffered a birth injury due to malpractice, it’s crucial to take legal action right away.
For more than twenty years, Freedland Harwin Valori Gander has worked to protect the rights of medical malpractice victims in Florida and nationwide. Our birth injury attorneys bring the experience, resources, and determination needed to take on large corporations and secure record-setting settlements for our clients, with over $2.6 billion recovered in total compensation to date. At FHVG, we handle each case with personalized attention and diligence, advocating for the best possible outcome for our clients.
Get started on your case today with a free consultation by contacting us online or calling 954-467-6400.
“Can’t recommend a better team of experts. They know their stuff and helped me with my case with ease.”
