The APGAR Score Calculator turns five quick bedside observations of a newborn into a single number from 0 to 10 that summarises how well the baby is coping with life outside the womb. It was devised by anaesthetist Virginia Apgar in 1952 and remains the standard rapid assessment in delivery rooms worldwide.
How it works
Five clinical signs are each scored 0, 1, or 2, and the five values are added together for a total out of 10. The acronym is also a mnemonic for the signs:
- Appearance — skin colour: 0 = blue/pale all over, 1 = body pink with blue extremities (acrocyanosis), 2 = completely pink.
- Pulse — heart rate: 0 = absent, 1 = below 100 bpm, 2 = 100 bpm or above.
- Grimace — reflex irritability to stimulation: 0 = no response, 1 = grimace, 2 = cry, cough, or sneeze.
- Activity — muscle tone: 0 = limp, 1 = some flexion, 2 = active motion.
- Respiration — breathing effort: 0 = absent, 1 = slow or irregular/weak cry, 2 = good, strong cry.
The total maps to three interpretation bands: 7–10 normal, 4–6 moderately low (the infant usually needs stimulation, suction, or oxygen), and 0–3 critically low (resuscitation is required).
Example and notes
A baby that is fully pink, has a heart rate of 140, cries on stimulation, moves
actively, and has a strong cry scores 2 + 2 + 2 + 2 + 2 = 10. A baby with
acrocyanosis (1), a pulse of 90 (1), a grimace (1), some flexion (1), and a weak
cry (1) scores 5, placing it in the moderate band.
The 1-minute score reflects the condition at birth; the 5-minute score better reflects the response to care and is the more clinically useful figure. Record each interval separately rather than relying on a single number.