Distress at Birth and the Apgar Score.

. The Apgar score, devised by Dr. Virginia Apgar, is a scoring system that eval­uates infant well-being at birth.¹⁵ The system addresses five categories (i.e., heart rate, respiratory effort, muscle tone, reflex irritability, and color) with a total score ranging from 0 to 10, depending on the degree to which these functions are presented (Table 2-1). Evaluations are per­formed at 1 minute and 5 minutes after delivery. A score of 0 to 3 is indicative of severe distress, 4 to 6 of moderate distress, and 7 to 10 of mild to no distress. Most infants score 6 to 7 at 1 minute and 8 to 9 at 5 minutes. If the score is 7 or less, the evaluation should be repeated every 5 min­utes until a score of 7 or greater is obtained. An abnormal score at 5 minutes is more predictive of problems with sur­vival and neurologic outcome than at 1 minute.¹²