Home / Blog / What Is an Apgar Score—and Can it Signal a Birth Injury?

The Apgar Score was developed to assess how newborns were affected by anesthesia given during delivery. It was never intended to be a tool to determine the risks of life-long complications from birth; however, it does provide a snapshot of the immediate physical condition of the baby.

This quick test can determine if the newborn is suffering from any injuries that need immediate treatment or identify issues that need closer monitoring.

Parts of an Apgar Score

The Apgar Score, developed in 1952 by Virginia Apgar, scores five areas with either a 0, 1, or 2. A doctor, nurse, or midwife looks at the baby’s breathing, heart rate, muscle tone, reflexes, and skin color, giving each an individual score based on what they see. These scores are then totaled to give the final Apgar Score.

Apgar scoring is done 1 minute and 5 minutes after birth. This helps healthcare providers understand how well the baby tolerated the birthing process and how well the baby is surviving outside of the womb.

The Apgar Score ranges from 0 to 10 total points. Newborns who score 7 or more points are considered normal. Scores less than 7 indicate that the baby is having difficulty adjusting to life outside the mother’s womb and needs medical assistance. An Apgar Score of 3 or less is a sign of major problems that require immediate intervention.

Causes of Low Apgar Scores

There are many reasons a newborn baby could have a low Apgar Score. A difficult birth or cesarean delivery can cause a low Apgar Score at 1 minute that will be normal or near-normal at the 5-minute score.

Fluid in the infant’s airway is another common cause of a low Apgar Score. The healthcare team can easily clear out the airway and apply supplemental oxygen to help the baby recover from breathing in fluid during birth.

Head trauma during delivery, infection, stroke, and umbilical cord injuries can all cause a low Apgar Score. Maternal factors such as uterine rupture or placental abruption can also affect the baby’s Apgar Score. The healthcare team will use the Apgar Score to quickly identify any possible issues and begin the appropriate treatment.

Future Health and the Apgar Score

Typically, the Apgar Score is conducted twice on every newborn baby. However, nurses, midwives, and doctors will complete Apgar Scores every 5 minutes if either of the first two Apgar Scores were below normal. This is done for the first 20 minutes of the newborn’s life for a total of 5 Apgar Scores. Healthcare providers use this to assess the effectiveness of their interventions and the physical improvement of the baby.

Infants with low Apgar Scores, especially scores below 3, at 5, 10, 15, and 20 minutes, have an increased risk of cerebral palsy. There is also an increased risk for brain damage or seizure disorders.

Many children with low Apgar Scores go on to live completely normal and healthy lives. With proper medical care, the issue causing the low Apgar Score can be solved, restoring health in the newborn.

A high Apgar Score doesn’t guarantee that an infant didn’t suffer a birth injury. Newborns with normal Apgar Scores can later show signs of brain injury, infection, or breathing problems. Slight changes in the score between assessments can indicate a potential problem that needs attention from healthcare providers.

Legal Assistance for Birth Injury

You trust your healthcare team to respond to delivery complications quickly and effectively. Appropriate diagnosis and treatment are required to minimize current and future health risks to you and your baby. When a medical team fails to recognize the significance of a low Apgar Score or fails to respond appropriately, that is negligence. If your baby has suffered injury or harm due to a negligent healthcare team, you may have a case for medical malpractice.

Birth injuries are complex medical cases. You want to work with trusted Indianapolis birth injury lawyers with years of experience to help you navigate your difficult case with ease.

The skilled attorneys at Wagner Reese understand your situation, and we can guide and support you during this difficult time. To begin your free, confidential birth injury case evaluation, contact us today.