Virginia Apgar developed a simple system (1952) for quickly evaluating the condition and viability of newborns. The Apgar Score System relies on five simple observations to be made by delivery room personnel of the infant within one minute of birth and periodically thereafter. The Apgar Score System soon came into general use throughout the United States and was adopted by several other countries.
Interpretation of scores
The test is generally done at one and five minutes after birth, and may be repeated later if the score is and remains low. Scores 7 and above are generally normal, 4 to 6 fairly low, and 3 and below are generally regarded as critically low.
A low score on the one-minute test may show that the neonate requires medical attention but does not necessarily indicate a long-term problem, particularly if the score improves at the five-minute test. An Apgar score that remains below 3 at later times—such as 10, 15, or 30 minutes—may indicate longer-term neurological damage, including a small but significant increase in the risk of cerebral palsy. However, the Apgar test's purpose is to determine quickly whether a newborn needs immediate medical care. It is not designed to predict long term health issues.
A score of 10 is uncommon, due to the prevalence of transient cyanosis, and does not substantially differ from a score of 9. Transient cyanosis is common, particularly in babies born at high altitude. A study that compared babies born in Peru near sea level with babies born at very high altitude (4340 m) found a significant average difference in the first Apgar score, but not the second. Oxygen saturation also was lower at high altitude.