{
  "id": "apgar-score",
  "version": "67fab224dea0",
  "status": "published",
  "name": "Apgar Score Calculator",
  "question": "What is the Apgar score?",
  "summary": "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.",
  "category": "health",
  "subcategory": "clinical",
  "url": "https://www.acalculator.org/health/apgar-score-calculator",
  "markdown": "https://www.acalculator.org/health/apgar-score-calculator.md",
  "kind": "function",
  "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.",
  "assumptions": [
    "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."
  ],
  "inputs": {
    "$schema": "https://json-schema.org/draft/2020-12/schema",
    "type": "object",
    "properties": {
      "c": {
        "title": "Color (appearance)",
        "description": "Skin color: completely pink, pink with blue hands and feet (acrocyanotic), or blue or pale.",
        "type": "string",
        "enum": [
          "2",
          "1",
          "0"
        ]
      },
      "hr": {
        "title": "Heart rate (pulse)",
        "description": "Heart rate: over 100 per minute, under 100 per minute, or absent.",
        "type": "string",
        "enum": [
          "2",
          "1",
          "0"
        ]
      },
      "r": {
        "title": "Reflex irritability (grimace)",
        "description": "Response to stimulation: cry or active withdrawal, a grimace, or no response.",
        "type": "string",
        "enum": [
          "2",
          "1",
          "0"
        ]
      },
      "t": {
        "title": "Muscle tone (activity)",
        "description": "Muscle tone: active motion, some flexion, or limp.",
        "type": "string",
        "enum": [
          "2",
          "1",
          "0"
        ]
      },
      "b": {
        "title": "Respiration",
        "description": "Breathing: good, crying; a weak cry or slow, irregular breathing; or absent.",
        "type": "string",
        "enum": [
          "2",
          "1",
          "0"
        ]
      },
      "min": {
        "title": "Minutes after birth",
        "description": "When the score was taken: at 1 and 5 minutes, then every 5 minutes up to 20.",
        "type": "string",
        "enum": [
          "1",
          "5",
          "10",
          "15",
          "20"
        ]
      }
    }
  },
  "outputs": {
    "score": {
      "label": "Apgar score",
      "description": "Color + heart rate + reflex irritability + muscle tone + respiration, 0 to 10.",
      "format": "integer"
    },
    "reading": {
      "label": "Reading",
      "description": "For a 5-minute score: 7 to 10 reassuring, 4 to 6 moderately abnormal, 0 to 3 low (ACOG 644).",
      "format": "text"
    }
  },
  "defaultAnswer": {
    "inputs": {
      "c": "1",
      "hr": "2",
      "r": "2",
      "t": "2",
      "b": "2",
      "min": "5"
    },
    "outputs": {
      "score": 9,
      "reading": "Reassuring (7 to 10)"
    },
    "text": "The Apgar score at 5 minutes is 9 out of 10: Reassuring (7 to 10)."
  },
  "examples": [
    {
      "given": {
        "c": "1",
        "hr": "2",
        "r": "2",
        "t": "2",
        "b": "2",
        "min": "5"
      },
      "expect": {
        "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) (hand calculation)"
    },
    {
      "given": {
        "c": "2",
        "hr": "2",
        "r": "2",
        "t": "2",
        "b": "2",
        "min": "5"
      },
      "expect": {
        "score": 10,
        "reading": "Reassuring (7 to 10)"
      },
      "source": "ACOG Committee Opinion 644, Fig. 1: every sign 2 gives the highest score, 10 (hand calculation in content.mdx)"
    },
    {
      "given": {
        "c": "1",
        "hr": "2",
        "r": "1",
        "t": "1",
        "b": "2",
        "min": "5"
      },
      "expect": {
        "score": 7,
        "reading": "Reassuring (7 to 10)"
      },
      "source": "ACOG Committee Opinion 644: 7 is the lowest reassuring 5-minute score (hand calculation in content.mdx)"
    },
    {
      "given": {
        "c": "1",
        "hr": "2",
        "r": "1",
        "t": "1",
        "b": "1",
        "min": "5"
      },
      "expect": {
        "score": 6,
        "reading": "Moderately abnormal (4 to 6)"
      },
      "source": "ACOG Committee Opinion 644: a 5-minute score of 4 to 6 is moderately abnormal (hand calculation in content.mdx)"
    },
    {
      "given": {
        "c": "0",
        "hr": "1",
        "r": "1",
        "t": "1",
        "b": "1",
        "min": "5"
      },
      "expect": {
        "score": 4,
        "reading": "Moderately abnormal (4 to 6)"
      },
      "source": "ACOG Committee Opinion 644: 4 is the lowest moderately abnormal score (hand calculation in content.mdx)"
    },
    {
      "given": {
        "c": "0",
        "hr": "1",
        "r": "1",
        "t": "0",
        "b": "1",
        "min": "5"
      },
      "expect": {
        "score": 3,
        "reading": "Low (0 to 3)"
      },
      "source": "ACOG Committee Opinion 644: a 5-minute score of 0 to 3 is low (hand calculation in content.mdx)"
    },
    {
      "given": {
        "c": "0",
        "hr": "0",
        "r": "0",
        "t": "0",
        "b": "0",
        "min": "5"
      },
      "expect": {
        "score": 0,
        "reading": "Low (0 to 3)"
      },
      "source": "ACOG Committee Opinion 644, Fig. 1: every sign 0 gives 0 (hand calculation in content.mdx)"
    },
    {
      "given": {
        "c": "0",
        "hr": "1",
        "r": "1",
        "t": "1",
        "b": "1",
        "min": "1"
      },
      "expect": {
        "score": 4,
        "reading": "Not graded (the bands are for the 5-minute score)"
      },
      "source": "ACOG Committee Opinion 644 grades the 5-minute score only; a 1-minute score is added up (hand calculation)"
    }
  ],
  "sources": [
    "American College of Obstetricians and Gynecologists Committee on Obstetric Practice and American Academy of Pediatrics Committee on Fetus and Newborn. Committee Opinion No. 644: The Apgar Score. Obstet Gynecol. 2015;126(4):e52-e55, reaffirmed 2025 (five signs scored 0, 1, or 2; Fig. 1, the expanded Apgar score form; 5-minute bands; timing; limits). https://doi.org/10.1097/AOG.0000000000001108 (free full text; ACOG page: https://www.acog.org/clinical/guidance/committee-opinion/2015/10/the-apgar-score, retrieved 2026-10-18)",
    "Simon LV, Shah M, Bragg BN. APGAR Score. StatPearls, last update January 31, 2026 (each sign’s levels in words; color often scores 1 at 5 minutes). https://www.ncbi.nlm.nih.gov/books/NBK470569/ (retrieved 2026-10-18)"
  ],
  "related": [
    "due-date",
    "baby-percentile"
  ],
  "changelog": [
    {
      "date": "2026-10-19",
      "note": "Published after this site's editorial review against the cited sources (no clinician review); the page notices say so."
    }
  ]
}