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Apgar Score for Birth Injury Diagnosis

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The Apgar score is an important tool used to evaluate the physical condition of an infant after birth. Often, an abnormal Apgar score indicates an underlying condition that may be temporary or permanent. When a newborn has suffered a birth injury, an abnormal Apgar score may be the first sign that something is wrong. As a parent, it is important to understand your baby’s Apgar score and why medical professionals must respond appropriately to Apgar score abnormalities.

Apgar Score Explained

Dr. Virginia Apgar devised the Apgar scoring system in 1952 as a means by which to quickly assess the condition of a newborn infant. The total Apgar score is generated by adding points from five specific metrics, each of which are assigned a score of 0, 1, or 2. The best possible Apgar score is 10, which indicates peak physical condition.

The five elements that comprise an Apgar score are:

  • Color (skin coloration): a score of 0 is blue or pale, a score of 2 is completely pink
  • Heart rate (pulse): a score of 0 is absent heart rate, a score of 2 is over 100 beats per minute (bpm)
  • Reflexes (reflex irritability): a score of 0 is no response to stimulation, a score of 2 is active motion (sneeze, cough, pull away)
  • Muscle tone (activity): a score of 0 is no movement, a score of 2 is active movement
  • Respiration (breathing): a score of 0 is no breathing, a score of 2 is a vigorous cry

Scores ranging from 7 to 10 are considered normal; scores ranging from 4 to 6 are considered abnormal; and scores between 1 and 3 are considered critically low.

The Apgar score is taken once at 1 minute after birth and once at 5 minutes after birth for all newborns. When an infant has a score of less than 7, the Apgar test should be conducted every 5 minutes thereafter until reaching the 20 minute point.

Why Apgar Score Matters

A newborn’s Apgar score may indicate an emergency or a medical condition that must be addressed. Although it is by no means an absolute method for determining birth injury or future health problems, low Apgar scores are associated with an increased risk for certain conditions. For instance, newborns with lower scores more frequently need resuscitation or breathing assistance. Also, infants with a low Apgar score at 5 minutes have an increased risk of cerebral palsy. In general, neurological conditions are associated with Apgar scores of 3 or less at 10, 15, and 20 minutes.

Some possible causes of low Apgar scores include head trauma during delivery, perinatal asphyxia, stroke, umbilical cord injuries, and undiagnosed infection.

It is important to remember that the Apgar score is intended for immediate evaluation of physical well-being. It is not a tool for predicting long-term outcomes. In other words, newborns with abnormal Apgar scores may go on to live as completely healthy adults. Likewise, babies with normal Apgar scores may still have suffered trauma during the labor and delivery process.

Apgar Scores and Birth Injuries in New Jersey

The delicate nature of the birthing process requires extreme caution and dilingent monitoring throughout. It is the medical professionals’ responsibility to prevent and respond appropriately when complications arise. It is also incumbent upon these healthcare providers to conduct Apgar testing and to take immediate action should your baby show signs of distress. If a doctor, hospital, nurse, or other medical professional failed to monitor or properly execute your baby’s care and he or she suffered harm, you may have grounds for a medical malpractice claim. For additional information related to neonatal assessment and birth injuries, contact our experienced New Jersey birth injury lawyers at (866)-708-8617 or online. We provide consultations free of charge and are available anytime to assist you.


Apgar Score, Committee on Obstetric Practice, American College of Obstetricians and Gynecologists

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