APGAR Score Chart – Interpretation Of Normal, Low, High Values (2024)

Within one to five minutes after your baby is born, doctors and nurses will assess your baby’s health and vital signs using the APGAR score. This is named after the creator of the said test Dr. Virginia APGAR in 1952, but it also stands for Appearance, Pulse, Grimace, Activity, and Respiration.

What Is The APGAR Score And Its Full Form?

APGAR score is a technique to assess the general well-being of your newborn. It uses five criteria, including Appearance, Pulse, Grimace, Activity, and Respiration.

This Is How Each Criterion Is Determined

  • Appearance By evaluating your baby’s skin color;
  • Pulse By evaluating your baby’s heart rate;
  • Grimace By evaluating your baby’s response or reflex irritability;
  • Activity By evaluating your baby’s muscle tone; and
  • Respiration By evaluating your baby’s breathing ability.

When Is APGAR Score Assessed?

APGAR score is assessed one within a minute and five minutes after your baby is born. There are rare instances when this test can be done within 10 minutes after birth. The first-minute score is used to ascertain how your baby tolerated the birthing process. On the other hand, the 5-minute score can show the condition of the baby outside your womb.

APGAR Score Chart

The following table describes the APGAR score chart;

Appearance 0
Blue; Bluish-gray; or Pale all over
Pink body, blue extremities
Pink all over
PulseAbsent< 100 beats/minute> 100 beats/minute
AbsentGrimace with stimulation/ facial movementCry, sneeze or cough, and withdrawal of food with stimulation
ActivityFloppy or limpFlexed limbsActively moving

APGAR Score Interpretation

There are five criteria in APGAR scoring. Each criterion is given points from 0 to 2. As you can see from the chart, each point means something. Your baby can receive at the most score of 10. But take note that it is rare for your baby to get a score of 10, this is because the test is conducted during the first few minutes after his birth.

What Does APGAR Score Of 3 or less Indicate?

In the first minute score, the APGAR score of 3 or less is an indication that your baby needs to be conducted with lifesaving measures. This range is “concerning.” But some babies, such as premature babies, babies who had complicated deliveries, and those born via cesarean, are expected to have lower APGAR scores.

What Does An APGAR Score Of 4 to 6 Indicate?

Scores ranging from 4 to 6 may indicate that your baby needs some assistance. For instance, your baby has an APGAR score of 5, and this means that he is “moderately abnormal.” But in this situation, your baby may require some breathing device. Using the 5-minute score, scores below seven does not really mean that your baby suffers from permanent health issues. Your healthcare provider might need to monitor your baby every 5 minutes until 20 minutes after birth.

What Does High APGAR Score Of 7 To 10 Indicate?

The higher the APGAR score, the healthier is your baby. So if your baby’s score is within this range, then he is considered healthy. For instance, having an APGAR score of 9 means “reassuring.”

What Can Cause Low APGAR Scores?

Sometimes, low APGAR scores are just normal, especially for newborn babies. It doesn’t really mean that your baby is not entirely healthy. He might need some time to adjust outside your womb. That is why low APGAR scores and development are often linked together. But there are cases when this indicated that your baby is suffering from birth-related complications such as infections, preterm birth, uterine hyperstimulation, uterine rupture, placental abruption, umbilical cord problems, and many more.

[Also Read: How To Prevent Birth Defects During Pregnancy]

What Happens When My Baby Has A Low APGAR Score?

The APGAR score shows your baby’s condition within minutes after birth. It does not indicate adverse neurological outcomes or predicts mortality. According to studies, newborns that have low APGAR scores are most likely to be at risk of abnormality and cerebral palsy. But, the probability of having cerebral palsy is low and rare. Remember that your baby’s score is affected by various factors such as maternal medications, gestational age, neurological and cardiorespiratory conditions, and resuscitation.


A minute after your baby is born, your healthcare provider will undertake a test for your baby. The APGAR score chart is used to assess your baby’s entire health status, APGAR score of 10 being the highest score your baby can obtain. If your baby gets lower than 7, it doesn’t really mean that he is unhealthy. Sometimes, it’s normal to have a lower APGAR score of 3 or less, especially to those babies who are premature, have complications, or born via cesarean.

APGAR Score Chart – Interpretation Of Normal, Low, High Values (1)

Dr. Ahmed Zayed

Doctor, author and fitness enthusiast, Ahmed Zayed, MD, is a surgery resident with a passion for helping people live a happy healthy life. He is the author of numerous health-related books and contributor to several medicine, health and wellbeing websites.

APGAR Score Chart – Interpretation Of Normal, Low, High Values (2024)


What does a high or low Apgar score mean? ›

The higher the score, the better the baby is doing after birth. A score of 7, 8, or 9 is normal and is a sign that the newborn is in good health. A score of 10 is very unusual, since almost all newborns lose 1 point for blue hands and feet, which is normal for after birth.

What are the values of Apgar score? ›

Neonatal Encephalopathy and Neurologic Outcome, Second Edition, published in 2014 by the College in collaboration with the AAP, defines a 5-minute Apgar score of 7–10 as reassuring, a score of 4–6 as moderately abnormal, and a score of 0–3 as low in the term infant and late-preterm infant 6.

Does Apgar score correlate with fetal acidosis? ›

Since fetal asphyxia is directly associated with neonatal acidosis, a low Apgar score in the face of normal pH and base deficit does not indicate an asphyxiated infant.

What is a high risk Apgar score for a newborn? ›

Any score lower than 7 on the Apgar test is a sign that your baby may need medical attention. The lower the score, the more help your baby needs to adjust to life outside of your womb.

What is a low Apgar score and the definition of birth asphyxia? ›

The term ''asphyxia'' should not be used unless the neonate meets all of the following conditions: (1) umbilical cord arterial pH less than 7 (whether meta- bolic or mixed), (2) Apgar score of 0 to 3 for longer than 5 minutes, (3) neuro- logic manifestations (eg, seizures, coma, or hypotonia), and (4) multisystemic ...

What is the Apgar score chart score? ›

What's considered a normal Apgar score? A score of 7 to 10 after five minutes is “reassuring.” A score of 4 to 6 is “moderately abnormal.” A score of 0 to 3 is concerning. It indicates a need for increased intervention, usually in assistance for breathing.

What is the normal score range for Apgar testing Quizlet? ›

Appearance, Pulses, Grimace, Activity, Reflex Irritability. Done at 1 and 5 minutes with a score of 0 for absent, 1 for decreased, and 2 for strongly positive. Scores 7 and above are generally normal, 4 to 6 fairly low, and 3 and below are generally regarded as critically low.

What is the normal head circumference of a newborn? ›

The average head circumference at birth is about 34.5 cm (13.5 in.). By the end of the first month, it increases to about 37.6 cm (15 in.).

What to do if the Apgar is low? ›

A baby who scores a 7 or above on the test is considered in good health. A lower score does not mean that your baby is unhealthy. It means that your baby may need some immediate medical care, such as suctioning of the airways or oxygen to help him or her breathe better.

How rare is a perfect Apgar score? ›

Very few babies get a perfect Apgar score – in fact at our hospital, fewer than 1 in 100 get that perfect 10.

Can you have an Apgar score of 0? ›

Background: Infants who have an Apgar score of zero at 10 min of age are known to have poor long-term prognosis. Expert committee guidelines suggest that it is reasonable to cease resuscitation efforts if the asphyxiated infant does not demonstrate a heart beat by 10 min of life.

How do you interpret family Apgar scores? ›

A score of 7 to 10 suggests a highly functional family. A score of 4 to 6 suggests a moderately dysfunctional family. A score of 0 to 3 suggests a severely dysfunctional family.

What is the most important component of the Apgar score? ›

Heart rate is evaluated by stethoscope. This is the most important assessment: If there is no heartbeat, the infant scores 0 for heart rate. If heart rate is less than 100 beats per minute, the infant scores 1 for heart rate.

What are normal cord gas values? ›

Reference Range:
ComponentVenous Cord BloodArterial Cord Blood
pH7.21 to 7.457.10 to 7.38
PCO227 to 55mmHg33 to 73mmHg
PO214 to 44mmHg5 to 32 mmHg
BaseExcessNo range has been established-8 to 1
3 more rows

Which baby would have the highest Apgar score? ›

The baby with the highest Apgar score would be the one that has the best scores for each of the five criteria. The five criteria for the Apgar test are appearance (skin color), pulse (heart rate), grimace (reflex), activity (muscle tone), and respiration (breathing).

What is the highest possible score of APGAR that still require resuscitation? ›

Apgar scores

Normal scores are 7 or greater at 1 minute and 8 or more at 5 minutes. An Apgar score of 7 or more indicates that the baby does not require assistance; scores between 6 and 4 indicate that help is needed; scores 3 or less signal the urgent need for resuscitation (Thomson 1993).

How do you remember the Apgar score? ›

Joseph Butterfield developed the mnemonic APGAR as a way to recall the five criteria of the scoring and used it in his hospital. His “APGAR” was the learning aid to recall; Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration.

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