When a child is born, one of the first diagnostic tests a doctor will perform is called an Apgar score. This score, created by Dr. Virginia Apgar in 1952, is the current standard of care to assess whether a newborn needs immediate medical attention.
Your first look at your child's health
The Apgar score can also be indicative of long-term health problems such as brain damage and cerebral palsy.
The 5 criteria of the Apgar score
While the score was originally named after Dr. Apgar, the name of the test also functions as an acronym for its five components:
- Appearance: Doctors assess the baby's skin color. Pink is indicative of a heathy baby, while blue or cyan (cyanosis) indicates a possible health problem.
- Pulse: Doctors measure the baby's pulse. For a perfect score, the pulse must be over 100 beats per minute. Lower scores indicate a low pulse or no pulse at all.
- Grimace: Short for "reflex irritability grimace." This measures how the baby responds to stimulation.
- Activity: Doctors measure whether the baby is flexing the arms and legs.
- Respiratory effort: A high score on this part of the test indicates strong, robust breathing, while lower scores indicate difficulty breathing.
Doctors assign a score of 0, 1 or 2 to each of these components, for a total score that ranges from 0-10. In general, scores of 7 or above indicate a healthy baby, scores of 4-6 are low and cause for some concern, and scores of 0-3 indicate a need for immediate medical attention.
Typically, the test is performed at 1 and 5 minutes after birth. It may be repeated at later times, such as 10, 15, 20 or 30 minutes after birth, if it remains low.
What the Apgar score says about your child's health
The intended purpose of the Apgar score is to assess a newborn's immediate medical needs and reduce infant mortality. In other words, a low Apgar score is not necessarily indicative of a long-term birth injury. There is a statistically significant correlation between low Apgar scores at later times after birth, such as 10, 20 or 30 minutes, and neurological damage, including birth injuries, such as cerebral palsy.
Low Apgar scores are associated with a number of medical conditions that can cause long-term birth injuries, including umbilical cord problems, uterine rupture, head trauma and improperly treated infections. Premature babies also tend to have low Apgar scores, as well as a higher incidence of cerebral palsy and other birth injuries.
Medical professionals have a responsibility to intervene
In short, a low Apgar score, even some time after birth, does not necessarily mean the child has a long-term injury. Likewise, it is entirely possible for a child with a long-term birth injury to have a high Apgar score. A low Apgar score is a red flag, however. Doctors have a responsibility to conduct further tests, to schedule a follow-up appointment with a pediatrician, and to communicate with you about what your baby's Apgar score means and what any foreseeable future risks may be.
If your child had low Apgar scores and has now been diagnosed with cerebral palsy or another birth injury, you do have recourse. One of the first steps you should take is to contact a birth injury attorney with experience handling such cases to help you get to the bottom of what happened.