Special thanks to Morgan Bechtle, PA-S, 2nd year clinical student from the Drexel University PA Program, who did the leg work on this eponym
Other Known Aliases – none
Definition – medical rating system used to evaluate the condition of a newborn immediately after birth.
Clinical Significance – first presented in 1952, it is a method for evaluating the status of a newborn and it’s response to resuscitation immediately after birth. It consists of five major criteria-heart rate, respiratory rate, muscle tone, reflex response, and color- which are observed and given a score of 0, 1, or 2 points. Today the test is performed at one minute and five minutes after birth. Neonates with a score of 7-10 generally require no further intervention, with lower scores indicating the possible need for assisted respiration.
History – Named after Virginia Apgar (1909-1974), who was a doctor at New York-Presbyterian and the first woman to become a full professor at Columbia University College of Physicians and Surgeons. She spent most of her career studying obstetrical anesthesia and its effect on the newborn. As a young doctor, Apgar was appalled by the treatment of premature, apneic babies. The practice at the time was to list apneic or malformed newborns as stillborn and place them out of sight to die. Outraged by this practice, Dr. Apgar developed a method that would ensure the observation and documentation of the true condition of each newborn during the first minute of life. The Apgar score was first published in 1953 in a paper titled “A Proposal for a New Method of Evaluation of the Newborn Infant” in which she highlighted the need for a “grading system of newborn infants [that can be used] as a basis for discussion and comparison of obstetric practices, types of maternal pain relief, and the effects resuscitation”. Later, her research went on to show that lower Apgar scores are associated with higher neonatal morbidity and mortality.
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