Neonatal & paediatrics

APGAR score calculator

Five signs at one and five minutes — the standard description of how a newborn arrived, scored while the resuscitation algorithm runs alongside it, never instead of it.

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Appearance (colour)
Pulse
Grimace (reflex irritability)
Activity (tone)
Respiration
Score at 1 and 5 minutes; repeat every 5 minutes while < 7.The score does not direct resuscitation — follow NLS/NRP algorithms. Reference: Apgar 1953.

How to read the result

APGAR falls into these published bands.

< 4Low
4 – 6Moderately abnormal
≥ 7Reassuring
Worked example

A term newborn at one minute: strong cry, heart rate above 100, grimaces on stimulation, some flexion of the limbs, and blue hands and feet.

APGAR 7 — reassuring

A reassuring transition: blue extremities and incomplete tone are common in the first minute and each cost a point without signalling trouble. The score is repeated at 5 minutes, and every 5 minutes after that only if it sits below 7.

Who this is for

For midwives, doctors, and nurses at every delivery: the standard record of a newborn's condition at 1 and 5 minutes — appearance, pulse, grimace, activity, and respiration, each scored 0–2 — assigned quickly at the resuscitaire while any resuscitation follows NLS/NRP in parallel. Repeated every 5 minutes while the score stays below 7.

How it works

What it calculates

The APGAR score — appearance, pulse, grimace, activity, respiration, each 0–2 — the standard description of a newborn's condition at 1 and 5 minutes.

Interpreting the result

7–10 is reassuring; 4–6 moderately abnormal; 0–3 low. A 5-minute score below 7 should be repeated every 5 minutes up to 20 minutes.

What it is not

APGAR describes condition — it does not direct resuscitation. Follow NLS/NRP algorithms in real time; the score is assigned alongside, not before, intervention.

Built on published evidence

  • The score does not direct resuscitation — follow NLS/NRP algorithms. Reference: Apgar 1953

Codification last reviewed 2026-08-28, and checked against published reference values in automated tests on every release — see the full evidence ledger.

Questions clinicians ask

Does the APGAR score direct resuscitation?

No — it describes the newborn's condition, it does not drive the intervention. Resuscitation follows NLS/NRP algorithms in real time, and the score is assigned alongside those steps, not before them.

When is the score repeated?

Routinely at 1 and 5 minutes after birth. While the score remains below 7, it is repeated every 5 minutes — up to 20 minutes — so the record captures the trajectory of the transition, not just two snapshots.

What do the bands mean?

7–10 is reassuring, 4–6 moderately abnormal, and 0–3 low. A perfect 10 is uncommon in the first minutes, because blue hands and feet (acrocyanosis) score 1 for appearance and are a normal early finding.

Does a low score predict long-term outcome?

Not on its own — the score, described by Virginia Apgar in 1953, was designed as a rapid description of condition after birth. It is the 5-minute score and its trend, alongside the clinical course, that carry meaning, and no single number labels a child's future.

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