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APGAR Score Calculator

Choose a level for each of the five signs to get the APGAR score out of 10, with the published band for the 5-minute score and the working. For midwives, nurses and doctors.

Minutes after birth
Appearance (skin colour): 1
Pulse (heart rate): 2
Grimace (reflex irritability): 1
Activity (muscle tone): 1
Respiration (breathing): 2
APGAR score
7 of 10
Published band
Reassuring
  • 1 (appearance) + 2 (pulse) + 1 (grimace) + 1 (activity) + 2 (respiration) = 7.
  • Scored at 1 minute. The bands (7–10 reassuring, 4–6 moderately abnormal, 0–3 low) are defined for the 5-minute score in term and late-preterm babies.
  • The score records how the baby is doing; it doesn't by itself show asphyxia or predict the baby's outcome.

For midwives, nurses and doctors: a published score (Apgar 1953; AAP and ACOG 2015), not a diagnosis. Resuscitation follows your neonatal resuscitation guideline, not the score.

The APGAR score

Sign012
Appearance (skin colour)Blue or pale all overBody pink, hands and feet bluePink all over
Pulse (heart rate)AbsentBelow 100 beats a minute100 or more beats a minute
Grimace (reflex irritability)No response to stimulationGrimace or weak cry when stimulatedCries, coughs, sneezes or pulls away when stimulated
Activity (muscle tone)Limp, no movementSome flexion of arms and legsActive movement, flexed arms and legs
Respiration (breathing)AbsentWeak, irregular or gaspingStrong cry, regular breathing

How to use it

  1. Choose the minute you're scoring at: 1, 5, or later if the 5-minute score was below 7.
  2. For each sign, choose the description that fits the baby.
  3. Read the total out of 10 and, at 5 minutes, the published band.

Sources: Apgar V. A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg 1953;32:260-7; American Academy of Pediatrics Committee on Fetus and Newborn and ACOG Committee on Obstetric Practice, The Apgar Score, Pediatrics 2015;136:819-22. Verify against your current guidelines. Everything runs in your browser.

Frequently asked questions

What does APGAR stand for?

Appearance (skin colour), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone) and Respiration. Dr Virginia Apgar published the score in 1953; the acronym came later as a memory aid.

How is the APGAR score calculated?

Each of the five signs is scored 0, 1 or 2 and the scores are added, for a total from 0 to 10. A baby who is pink with blue hands and feet (1), has a pulse of 100 or more (2), grimaces when stimulated (1), has some flexion (1) and cries strongly (2) scores 7.

When is the APGAR score taken?

At 1 minute and 5 minutes after birth. If the 5-minute score is below 7, it's repeated every 5 minutes up to 20 minutes.

What is a normal APGAR score?

For the 5-minute score in term and late-preterm babies, the American Academy of Pediatrics and ACOG describe 7–10 as reassuring, 4–6 as moderately abnormal and 0–3 as low. Many healthy babies score 7 or 8 at 1 minute, often losing a point for blue hands and feet.

Does a low score mean the baby will have problems?

Not on its own. The score describes how the baby is doing at that moment; AAP and ACOG note it shouldn't be used alone to show asphyxia or to predict a baby's long-term outcome. Resuscitation decisions follow neonatal resuscitation guidelines, not the score.

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