Skip to main content
Canadian Family Physician logoLink to Canadian Family Physician
. 1983 Apr;29:755–757.

The Apgar in Perspective

Frank N Schnell
PMCID: PMC2154165  PMID: 21283450

Abstract

The Apgar score is assigned to virtually every child born in a North American hospital. While it was originally proposed as a grading system for comparing the results of perinatal events, it has been used as a guide to resuscitation of the newborn, as well as an index of the infant's longer term morbidity. The Apgar score has undoubtedly focused attention on the neonate, but it is often improperly used as a statistical method and is not useful as a resuscitation guide or prognosticator. It should be viewed as a biostatistical tool, and used as such.

Full text

PDF
755

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. APGAR V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953 Jul-Aug;32(4):260–267. [PubMed] [Google Scholar]
  2. APGAR V., HOLADAY D. A., JAMES L. S., WEISBROT I. M., BERRIEN C. Evaluation of the newborn infant; second report. J Am Med Assoc. 1958 Dec 13;168(15):1985–1988. doi: 10.1001/jama.1958.03000150027007. [DOI] [PubMed] [Google Scholar]
  3. APGAR V., JAMES L. S. Further observations on the newborn scoring system. Am J Dis Child. 1962 Oct;104:419–428. doi: 10.1001/archpedi.1962.02080030421015. [DOI] [PubMed] [Google Scholar]
  4. Apgar V. The newborn (Apgar) scoring system. Reflections and advice. Pediatr Clin North Am. 1966 Aug;13(3):645–650. doi: 10.1016/s0031-3955(16)31874-0. [DOI] [PubMed] [Google Scholar]
  5. Chamberlain G., Banks J. Assessment of the Apgar score. Lancet. 1974 Nov 23;2(7891):1225–1228. doi: 10.1016/s0140-6736(74)90745-4. [DOI] [PubMed] [Google Scholar]
  6. Crawford J. S., Davies P., Pearson J. F. Significance of the individual components of the Apgar score. Br J Anaesth. 1973 Feb;45(2):148–158. doi: 10.1093/bja/45.2.148. [DOI] [PubMed] [Google Scholar]
  7. DRAGE J. S., KENNEDY C., SCHWARZ B. K. THE APGAR SCORE AS AN INDEX OF NEONATAL MORTALITY. A REPORT FROM THE COLLABORATIVE STUDY OF CEREBRAL PALSY. Obstet Gynecol. 1964 Aug;24:222–230. [PubMed] [Google Scholar]
  8. Drage J. S., Berendes H. Apgar scores and outcome of the newborn. Pediatr Clin North Am. 1966 Aug;13(3):637–643. [PubMed] [Google Scholar]
  9. Drage J. S., Kennedy C., Berendes H., Schwarz B. K., Weiss W. The Apgar score as an index of infant morbidity. A report from the collaborative study of cerebral palsy. Dev Med Child Neurol. 1966 Apr;8(2):141–148. doi: 10.1111/j.1469-8749.1966.tb01719.x. [DOI] [PubMed] [Google Scholar]
  10. ECKENHOFF J. E., HOFFMAN G. L., DRIPPS R. D. N-allyl normorphine: an antagonist to the opiates. Anesthesiology. 1952 May;13(3):242–251. doi: 10.1097/00000542-195205000-00002. [DOI] [PubMed] [Google Scholar]
  11. Gerhardt T., Bancalari E., Cohen H., Macias-Loza M. Respiratory depression at birth--value of Apgar score and ventilatory measurements in its detection. J Pediatr. 1977 Jun;90(6):971–975. doi: 10.1016/s0022-3476(77)80574-x. [DOI] [PubMed] [Google Scholar]
  12. Gregory G. A. Resuscitation of the newborn. Anesthesiology. 1975 Aug;43(2):225–237. doi: 10.1097/00000542-197508000-00008. [DOI] [PubMed] [Google Scholar]
  13. HAPKE F. B., BARNES A. C. The obstetric use and effect of fetal respiration of nisentil. Am J Obstet Gynecol. 1949 Oct;58(4):799–801. doi: 10.1016/s0002-9378(16)39240-7. [DOI] [PubMed] [Google Scholar]
  14. JAMES L. S., WEISBROT I. M., PRINCE C. E., HOLADAY D. A., APGAR V. The acid-base status of human infants in relation to birth asphyxia and the onset of respiration. J Pediatr. 1958 Apr;52(4):379–394. doi: 10.1016/s0022-3476(58)80058-x. [DOI] [PubMed] [Google Scholar]
  15. Jennett R. J., Warford H. S., Kreinick C., Waterkotte G. W. Apgar index: a statistical tool. Am J Obstet Gynecol. 1981 May 15;140(2):206–212. doi: 10.1016/0002-9378(81)90109-5. [DOI] [PubMed] [Google Scholar]
  16. Khazin A. F., Hon E. H., Quilligan E. J. Biochemical studies of the fetus. 3. Fetal base and Apgar scores. Obstet Gynecol. 1969 Oct;34(4):592–609. [PubMed] [Google Scholar]
  17. Marx G. F., Mahajan S., Miclat M. N. Correlation of biochemical data with Apgar scores at birth and at one minute. Br J Anaesth. 1977 Aug;49(8):831–833. doi: 10.1093/bja/49.8.831. [DOI] [PubMed] [Google Scholar]
  18. Modanlou H., Yeh S. Y., Hon E. H., Forsythe A. Fetal and neonatal biochemistry and Apgar scores. Am J Obstet Gynecol. 1973 Dec 1;117(7):942–951. doi: 10.1016/0002-9378(73)90066-5. [DOI] [PubMed] [Google Scholar]
  19. Nelson K. B., Ellenberg J. H. Apgar scores as predictors of chronic neurologic disability. Pediatrics. 1981 Jul;68(1):36–44. [PubMed] [Google Scholar]
  20. Nelson K. B., Ellenberg J. H. Neonatal signs as predictors of cerebral palsy. Pediatrics. 1979 Aug;64(2):225–232. [PubMed] [Google Scholar]
  21. ROSENBLITH J. F. PROGNOSTIC VALUE OF BEHAVIORAL ASSESSMENTS OF NEONATES. Biol Neonat. 1964;6:76–103. doi: 10.1159/000239888. [DOI] [PubMed] [Google Scholar]
  22. Roberts R. B. Letter: Assessment of the Apgar score. Lancet. 1975 Jan 18;1(7899):164–165. doi: 10.1016/s0140-6736(75)91460-9. [DOI] [PubMed] [Google Scholar]
  23. Scanlon J. W. How is the baby?: the Apgar score revisited. Clin Pediatr (Phila) 1973 Feb;12(2):61–63. doi: 10.1177/000992287301200201. [DOI] [PubMed] [Google Scholar]
  24. Serunian S. A., Broman S. H. Relationship of Apgar scores and Bayley mental and motor scores. Child Dev. 1975 Sep;46(3):698–700. [PubMed] [Google Scholar]
  25. Sykes G. S., Molloy P. M., Johnson P., Gu W., Ashworth F., Stirrat G. M., Turnbull A. C. Do Apgar scores indicate asphyxia? Lancet. 1982 Feb 27;1(8270):494–496. doi: 10.1016/s0140-6736(82)91462-3. [DOI] [PubMed] [Google Scholar]
  26. Tenbrinck M. S. Significance of the Apgar score in the evaluation of mental retardation. J Am Med Womens Assoc. 1974 Dec;29(12):555-6, 558-60. [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES