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Apgar Score: Your Newborn's First Test

What Does My Baby's Apgar Score Mean?

A score of 7, 8, 9, or 10 is perfectly normal. Don't feel bad if your baby didn't get a 10 -- most babies don't, simply because of their blue hands and feet. A score lower than 7 indicates that the baby is having a bit of trouble adjusting to life outside the womb and may need some help. This help may come in the form of a little physical stimulation and jostling, oxygen and airway clearing to help breathing, or other interventions as appropriate. Most of the time, a low one-minute score rises to almost normal by the time the five-minute score is taken.
 
Interestingly, the Apgar score doesn't have much predictive value -- it's not designed to help predict whether or not a baby will have problems later in life. In fact, studies generally show that a low one-minute Apgar score isn't really associated with a high risk of death or problems. A score that is still low at five minutes seems to be associated with a higher risk of newborn death. Babies with a five-minute score of less than 4 seem to have a higher risk of cerebral palsy, although reassuringly, the vast majority (about 90 percent) of those babies do not develop cerebral palsy. 
 
In most cases, a baby's Apgar score isn't something to be concerned with, especially after the fact and especially for normal children. The score helps to evaluate how well and how quickly the baby is adapting to the outside world very shortly after birth, but it is generally not a particularly useful predictor of future intelligence or health.
 

Limitations of the Apgar Score

The standard Apgar scoring system doesn't work well for premature babies or babies who are already being resuscitated (receiving CPR, oxygen, or other means or medications to help them breathe or survive outside the womb). A healthy premature baby with no major problems may still score low, simply due to the physical immaturity of the baby.
 
An expanded Apgar, which takes into account the resuscitation measures that are being provided, can be used in these situations, especially for very premature babies.
 
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