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APGAR Scores

What Are APGAR Scores?

The APGAR test is a rapid assessment of newborn well-being, performed one and five minutes after birth. The first score assesses how the baby tolerated the birthing process, and the second assesses how the baby is doing outside the mother’s womb. The test examines the baby’s breathing effort, heart rate, muscle tone, reflexes and skin color. The test scores each category on a scale of 0 to 2, with 2 being the best score. Below, our birth injury lawyers in Chicago discuss APGAR scores in more detail.
APGAR stands for:
  • Appearance (skin color)
  • Pulse (heart rate)
  • Grimace response (reflex)
  • Activity (muscle tone)
  • Respiration (breathing rate and effort)

How Can Medical Practitioners Determine the Health of a Newborn with the APGAR Test?

Practitioners score each of the categories in the APGAR test and add them up. 10 is the highest possible score. The practitioner gives a score of 2 in each category when the practitioner observes normal signs/behaviors. The practitioner gives a score of 1 when lower than normal signs are observed. And, when signs are absent or abnormal, the practitioner gives scores of 0.


2 (Two)

1 (One)

0 (Zero)


(skin color)
Normal pink color all over, including in the hands and feet
Normal pink color all over except for the hands and feet, which may be bluish
Blue or grey color, or pale all over


(heart rate)
Normal (over 100 beats per minute)
Lower than 100 beats per minute
No pulse

Grimace response

Pulls away, coughs, sneezes, or cries with stimulation
Facial movement only with stimulation
No response to stimulation


(muscle tone)
Active movement
Little movement
No movement


(breathing rate and effort)
Good cry, normal breathing rate and effort
Weak cry, slow or irregular breathing
No breathing

What Causes a Low APGAR Score?

Potential causes of a low APGAR score may include:
  • Prolonged labor/delivery
  • Head trauma (the use of forceps or vacuum extractors, macrosomia, and cephalopelvic disproportion all increase the likelihood of trauma to an infant’s head and potential brain damage)
  • Premature birth
  • Oxygen deprivation

What Is a Healthy APGAR Score?

A healthy APGAR score ranges from 7 to 10. APGAR scores between 4 and 6 indicate that some medical intervention may be required. Scores under 4 may indicate severe respiratory distress, calling for lifesaving measures. For infants with a score less than 7, the test is performed at five-minute intervals until the 20-minute mark. The APGAR score offers medical practitioners a prompt way to determine if intervention is needed to help the infant breathe.

Understanding Abnormal APGAR Scores

APGAR score interpretation helps professionals to determine the immediate well-being of a baby. It does not predict neonatal mortality, neurologic outcome, nor the future health of the child. Lower scores do not always correlate to permanent health problems, and similarly, higher APGAR scores do not rule out the possibility of brain damage, such as hypoxic-ischemic encephalopathy (HIE).
However, if the APGAR score is low at 10, 15, or 30 minutes after birth, there is a higher risk that the baby will suffer long-term brain damage, cerebral palsy, and/or seizure disorders. In these cases, babies require immediate medical attention.

Other Types of Infant Well-Being Scoring

Aside from the APGAR test, practitioners may also administer a Ballard Maturational Assessment. This assessment is also known as a New Ballard Score. It is a commonly used technique to assess gestational age. Doctors will assess a newborn based on several characteristics (physical and neuromuscular) to evaluate the accuracy of the baby’s gestational age, down to 20 weeks gestation. The Downe’s Score and the Silverman Anderson Score are methods doctors may use to determine respiratory distress in a newborn.

Did Your Child Receive a Low APGAR Score and Suffers From Birth Injuries? Contact Our Birth Injury Lawyers in Chicago

If your child received a low APGAR score and suffers from birth injuries, it may be a result of medical malpractice. Consider speaking to our Chicago birth injury lawyers about your unique situation.
Call us at (877) 262-9767 or contact us online to schedule a free consultation. We represent families nationwide and have offices in Chicago IL, Baltimore MD, New York NY, and Wilmington DE.