Apgar Score
Score* | ||||
|---|---|---|---|---|
Criteria | Mnemonic | 0 | 1 | 2 |
Color† | Appearance | All blue pale | Pink body, blue extremities | All pink |
Heart rate | Pulse | Absent | < 100 beats/minute | > 100 beats/minute |
Reflex response to nasal catheter/tactile stimulation | Grimace | None | Grimace | Sneeze, cough |
Muscle tone | Activity | Limp | Some flexion of extremities | Active |
Respiration | Respiration | Absent | Irregular, slow | Good, crying |
* A total score of 7–10 at 5 minutes is considered normal; 4–6, intermediate; and 0–3, low. † The color (appearance) component as originally described may be less useful prognostically for non-White newborns; modifications to the scoring system have been suggested. Central cyanosis may be evaluated more reliably in the lips, mucous membranes, and tongue in non-White newborns. See Tillman D, Guillory C, Raphael JL. Color outside the lines: rethinking Apgar scores for equity. Pediatr Res. Published online November 11, 2024. doi:10.1038/s41390-024-03701-7 and Fair FJ, Furness A, Higginbottom G, Oddie SJ, Soltani H. Systematic review of Apgar scores & cyanosis in Black, Asian, and ethnic minority infants. Pediatr Res. 2025;97(3):939-952. doi:10.1038/s41390-024-03543-3. | ||||