What is the Apgar score?
Pick what was seen for each of the five Apgar signs to add up the score out of 10, and read a 5-minute score with the bands of ACOG and the American Academy of Pediatrics. For information only. This is not medical advice or a diagnosis. Do not use it to make treatment decisions without a clinician. No licensed clinician has reviewed this page.
- Apgar score
- 9
The Apgar score at 5 minutes is 9 out of 10: Reassuring (7 to 10).
- Reading
- Reassuring (7 to 10)
Apgar score: 9. The Apgar score at 5 minutes is 9 out of 10: Reassuring (7 to 10).
Apgar score out of 10
This calculator gives general information only. It is not medical advice and does not replace a doctor or other health care provider. Talk with a professional about your results. Terms of use
How to calculate
Adds up the five Apgar signs of a newborn (color, heart rate, reflex irritability, muscle tone, and breathing), each scored 0 to 2, to a score of 0 to 10, and reads a 5-minute score with the ACOG and AAP bands.
Example with the default inputs (Color (appearance) 1: Acrocyanotic (blue hands and feet), Heart rate (pulse) 2: Over 100 per minute, Reflex irritability (grimace) 2: Cry or active withdrawal, Muscle tone (activity) 2: Active motion, Respiration 2: Good, crying, Minutes after birth 5 minutes): The Apgar score at 5 minutes is 9 out of 10: Reassuring (7 to 10).
Method: Apgar score = color + heart rate + reflex irritability + muscle tone + respiration, each 0, 1, or 2 (ACOG 644, Fig. 1). A 5-minute score of 7 to 10 is reassuring, 4 to 6 moderately abnormal, and 0 to 3 low.
- Each sign is scored as seen at that minute, on the levels of the ACOG and AAP expanded Apgar score form.
- The bands apply to the 5-minute score of babies born at term or late preterm; scores at other times are not graded.
- The score describes the baby at one moment; it does not decide resuscitation and does not predict one baby’s outcome.
Worked examples
Each example is checked against the calculator on every build.
- Color (appearance) 1: Acrocyanotic (blue hands and feet), Heart rate (pulse) 2: Over 100 per minute, Reflex irritability (grimace) 2: Cry or active withdrawal, Muscle tone (activity) 2: Active motion, Respiration 2: Good, crying, Minutes after birth 5 minutes gives Apgar score 9, Reading Reassuring (7 to 10).Source: ACOG Committee Opinion 644: 1 + 2 + 2 + 2 + 2 = 9 at 5 minutes, reassuring (7 to 10) ()
- Color (appearance) 2: Completely pink, Heart rate (pulse) 2: Over 100 per minute, Reflex irritability (grimace) 2: Cry or active withdrawal, Muscle tone (activity) 2: Active motion, Respiration 2: Good, crying, Minutes after birth 5 minutes gives Apgar score 10, Reading Reassuring (7 to 10).Source: ACOG Committee Opinion 644, Fig. 1: every sign 2 gives the highest score, 10
- Color (appearance) 1: Acrocyanotic (blue hands and feet), Heart rate (pulse) 2: Over 100 per minute, Reflex irritability (grimace) 1: Grimace, Muscle tone (activity) 1: Some flexion, Respiration 2: Good, crying, Minutes after birth 5 minutes gives Apgar score 7, Reading Reassuring (7 to 10).Source: ACOG Committee Opinion 644: 7 is the lowest reassuring 5-minute score
- Color (appearance) 1: Acrocyanotic (blue hands and feet), Heart rate (pulse) 2: Over 100 per minute, Reflex irritability (grimace) 1: Grimace, Muscle tone (activity) 1: Some flexion, Respiration 1: Weak cry, hypoventilation, Minutes after birth 5 minutes gives Apgar score 6, Reading Moderately abnormal (4 to 6).Source: ACOG Committee Opinion 644: a 5-minute score of 4 to 6 is moderately abnormal
- Color (appearance) 0: Blue or pale, Heart rate (pulse) 1: Under 100 per minute, Reflex irritability (grimace) 1: Grimace, Muscle tone (activity) 1: Some flexion, Respiration 1: Weak cry, hypoventilation, Minutes after birth 5 minutes gives Apgar score 4, Reading Moderately abnormal (4 to 6).Source: ACOG Committee Opinion 644: 4 is the lowest moderately abnormal score
- Color (appearance) 0: Blue or pale, Heart rate (pulse) 1: Under 100 per minute, Reflex irritability (grimace) 1: Grimace, Muscle tone (activity) 0: Limp, Respiration 1: Weak cry, hypoventilation, Minutes after birth 5 minutes gives Apgar score 3, Reading Low (0 to 3).Source: ACOG Committee Opinion 644: a 5-minute score of 0 to 3 is low
- Color (appearance) 0: Blue or pale, Heart rate (pulse) 0: Absent, Reflex irritability (grimace) 0: No response, Muscle tone (activity) 0: Limp, Respiration 0: Absent, Minutes after birth 5 minutes gives Apgar score 0, Reading Low (0 to 3).Source: ACOG Committee Opinion 644, Fig. 1: every sign 0 gives 0
- Color (appearance) 0: Blue or pale, Heart rate (pulse) 1: Under 100 per minute, Reflex irritability (grimace) 1: Grimace, Muscle tone (activity) 1: Some flexion, Respiration 1: Weak cry, hypoventilation, Minutes after birth 1 minute gives Apgar score 4, Reading Not graded (the bands are for the 5-minute score).Source: ACOG Committee Opinion 644 grades the 5-minute score only
Medical disclaimer
This calculator is for information and education only. It is not medical advice, and its result is not a diagnosis. Do not use it to start, stop, or change a treatment without a clinician who knows your health history. No licensed clinician has reviewed this page. This site's editors checked the formulas and worked examples against published sources. If you think you have a medical emergency, call your local emergency number.
When this does not apply. The 7 to 10, 4 to 6, and 0 to 3 bands are for the 5-minute score of babies born at term or late preterm (ACOG Committee Opinion 644); the page adds up a score at 1, 10, 15, or 20 minutes but does not grade it. A healthy preterm baby may score low only because of immaturity. Sedation or anesthesia of the mother, birth defects, gestational age, injury, and differences between observers all change the score, and a score given during resuscitation is not the same as one given to a baby who breathes on its own. The score alone is not evidence of asphyxia and does not predict one baby's outcome.
How it works
Each sign gets 0, 1, or 2 points, as on the expanded Apgar score form (ACOG Committee Opinion 644, Fig. 1):
| Sign | 0 points | 1 point | 2 points |
|---|---|---|---|
| Color | Blue or pale | Acrocyanotic (pink body, blue hands and feet) | Completely pink |
| Heart rate | Absent | Under 100 per minute | Over 100 per minute |
| Reflex irritability | No response | Grimace | Cry or active withdrawal |
| Muscle tone | Limp | Some flexion | Active motion |
| Respiration | Absent | Weak cry, hypoventilation | Good, crying |
Apgar score = color + heart rate + reflex irritability + muscle tone + respiration, from 0 to 10.
Reading. For a score taken at 5 minutes: 7 to 10 is reassuring, 4 to 6 moderately abnormal, and 0 to 3 low. For a score taken at 1, 10, 15, or 20 minutes, the page shows the total and the words "Not graded (the bands are for the 5-minute score)".
Assumptions
- Each sign is scored as it was seen at that minute.
- The result is for education. It is not medical advice.
Worked examples by hand
Page default. Blue hands and feet (1), heart rate over 100 (2), cries (2), active motion (2), good cry (2) at 5 minutes: 1 + 2 + 2 + 2 + 2 = 9, reassuring.
Every sign 2. 2 + 2 + 2 + 2 + 2 = 10, reassuring.
At the reassuring edge. 1 + 2 + 1 + 1 + 2 = 7 at 5 minutes: reassuring (7 to 10).
Moderately abnormal. 1 + 2 + 1 + 1 + 1 = 6 at 5 minutes: moderately abnormal (4 to 6). And 0 + 1 + 1 + 1 + 1 = 4: still moderately abnormal.
Low. 0 + 1 + 1 + 0 + 1 = 3 at 5 minutes: low (0 to 3). Every sign 0 gives 0, low.
At 1 minute. 0 + 1 + 1 + 1 + 1 = 4 at 1 minute: not graded, because the bands are for the 5-minute score.
Other questions people ask
What is the Apgar score?
A quick, standard check of a newborn right after birth, devised by Dr. Virginia Apgar in 1952. Five signs (color, heart rate, reflex irritability, muscle tone, and breathing) each get 0, 1, or 2 points, for a total of 0 to 10.
When is the Apgar score taken?
At 1 minute and at 5 minutes after birth, for every baby. If the 5-minute score is under 7, the Neonatal Resuscitation Program guidelines repeat it every 5 minutes for up to 20 minutes (ACOG Committee Opinion 644).
What do the scores mean?
ACOG and the AAP call a 5-minute score of 7 to 10 reassuring, 4 to 6 moderately abnormal, and 0 to 3 low, in babies born at term or late preterm. The bands are for the 5-minute score, so this page does not grade the score at other times.
Does a low Apgar score mean a baby will have problems?
Not on its own. The score does not predict one baby’s death or brain outcome, and the score alone is not evidence of a lack of oxygen at birth (asphyxia). A 1-minute score of 0 to 3 does not predict any one baby’s outcome. In large groups a low 5-minute score goes with a higher risk of cerebral palsy, but most babies with low scores do not develop it.
Why do so few babies score 10?
Color often scores 1, because blue hands and feet are common in healthy newborns, even at 5 minutes (StatPearls). A score of 7 to 10 at 5 minutes is reassuring.
Is the Apgar score used to decide on resuscitation?
No. Resuscitation starts before the 1-minute score is given, so the score is not used to decide whether to start it, which steps to take, or when. A score given during resuscitation is not the same as a score given to a baby who breathes on its own (ACOG Committee Opinion 644).
Why can a preterm baby score lower?
Tone, color, and reflexes depend partly on how mature the baby is. ACOG notes that a healthy preterm baby may get a low score only because of immaturity.