Apgar score calculator

What is the Apgar score?

The Apgar score is a quick, standard way to describe a newborn’s condition in the first minutes of life, and how the baby responds to help if help is needed. Dr. Virginia Apgar, an anesthesiologist at Columbia University, devised it in 1952 and published it in 1953 in Current Researches in Anesthesia and Analgesia. A clinician rates five signs, each 0, 1 or 2, and adds them up for a total from 0 to 10. The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG) call it “an accepted and convenient method” for reporting the status of the newborn.

What do the five signs mean?

Appearance (color): 0 blue or pale all over, 1 pink body with blue hands and feet, 2 pink all over. Pulse: 0 no heartbeat, 1 under 100 beats a minute, 2 100 or more. Grimace (reflex irritability, the response to stimulation): 0 no response, 1 grimace or weak cry, 2 cry, cough or sneeze. Activity (muscle tone): 0 limp, 1 some flexion, 2 active motion. Respiration (breathing effort): 0 not breathing, 1 slow, irregular or weak, 2 strong cry. Sources word the heart-rate cutoff slightly differently, “over 100” or “100 or more”, and only a rate of exactly 100 is affected.

What is a normal Apgar score?

A score of 7 to 10 is considered reassuring, 4 to 6 moderately abnormal and 0 to 3 low; the bands are given for full-term and late preterm babies at 5 minutes. Many healthy babies lose a point for color because hands and feet stay bluish for a while after birth, so a score of 9 is common and a healthy baby does not need a 10. Example: color 1, pulse 2, grimace 2, activity 1 and respiration 2 gives 8, which is reassuring.

When is it scored?

At 1 and 5 minutes after birth for every baby. When the score is below 7, the Neonatal Resuscitation Program guidelines, as summarized in StatPearls, call for continuing to record it every 5 minutes, up to 20 minutes, which helps track the response to care. The two scores say different things. The 1-minute score reflects how the baby tolerated birth and often rises: a baby scoring 4 at 1 minute may score 9 at 5 minutes. The 5-minute score shows how the baby is doing outside the womb. Resuscitation, when needed, does not wait for the 1-minute score.

What does the Apgar score not tell you?

According to AAP and ACOG Committee Opinion 644 (2015, reaffirmed in 2025), the Apgar score alone cannot be considered evidence of, or a consequence of, asphyxia (lack of oxygen), does not predict individual neonatal mortality or neurologic outcome, and should not be used for that purpose. In large populations a low 5-minute score goes together with a higher risk of death and of cerebral palsy, but most babies with low scores do not develop cerebral palsy, and the score cannot say what will happen to one baby. A low 1-minute score by itself does not predict serious or long-term problems.

Does gestational age or medication change the score?

Yes. Scores vary with gestational age, so a premature baby may score lower for reasons that are normal for the age. Medication given to the mother, anesthesia, drug use and birth defects can also affect it, and some signs, such as color and tone, are partly a matter of the observer’s judgment. A score assigned while the baby is being resuscitated is not equivalent to the score of a baby breathing without help, because the interventions change the signs themselves. For this reason AAP and ACOG encourage an expanded Apgar form that records the interventions alongside the numbers.

Does skin color affect the score?

The color item describes a baby as blue, pink with blue hands and feet, or pink all over, which is easier to judge in a baby with light skin. StatPearls notes that color can be misleading in non-white babies, and an article in the medical literature is titled “The Apgar score and race: why healthy babies are supposed to be ‘pink’.” Keep this in mind when you read a color score.

Limits of this tool

This calculator only adds the five numbers and applies the published bands. A real Apgar score is assigned by the person caring for the baby, who judges each sign in the moment; the score is somewhat subjective, which is why two observers do not always agree. The score also does not decide whether to resuscitate: under the Neonatal Resuscitation Program, help begins before the 1-minute score is given. Do not use the page to interpret a particular baby’s numbers or to second-guess care. Parents with questions about their baby’s scores should ask the delivering clinician or the baby’s pediatrician.

Common mistakes

The commonest errors are treating a low 1-minute score as a verdict, reading the 0 to 3 band as a prediction of disability, and adding up scores from different times. The score is also sometimes read as a diagnosis of oxygen lack, which AAP and ACOG say it cannot be. A baby’s Apgar score at 1 minute and at 5 minutes describe two different moments and are never averaged.

Sources: Apgar V, “A proposal for a new method of evaluation of the newborn infant,” Curr Res Anesth Analg 1953;32:260–267; American Academy of Pediatrics Committee on Fetus and Newborn and American College of Obstetricians and Gynecologists Committee on Obstetric Practice, “The Apgar Score,” ACOG Committee Opinion No. 644 / Pediatrics 2015;136:819–822 (reaffirmed by ACOG in 2025), acog.org; Simon LV, Shah M, Bragg BN, “APGAR Score,” StatPearls (NCBI Bookshelf, updated January 2026), for the criteria table, the bands and the timing; MedlinePlus, “Apgar score,” for the plain-language criteria. Related: baby growth percentile calculator, adjusted age calculator, due date calculator, baby formula amount calculator.

For general information only — not medical advice. Talk with your baby’s doctor or another health professional about your baby’s health; an Apgar score on its own does not diagnose anything. How we check our calculators.