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    Limitations of APGAR Scoring

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    Fatima Llana Tolentino
    The Apgar score provides a standardized assessment of a newborn's condition immediately after birth, but it has numerous limitations. There are many factors that can influence the Apgar score, including maternal sedation or anesthesia, congenital malformations, gestational age, trauma, and differences in interpretation between caregivers. In addition, a biochemical disturbance must be significant enough before it affects the Apgar score. The Apgar score alone cannot predict individual neonatal mortality or neurologic outcomes.

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    Limitations of APGAR Scoring

    Uploaded by

    Fatima Llana Tolentino
    69 views2 pages
    The Apgar score provides a standardized assessment of a newborn's condition immediately after birth, but it has numerous limitations. There are many factors that can influence the Apgar score, including maternal sedation or anesthesia, congenital malformations, gestational age, trauma, and differences in interpretation between caregivers. In addition, a biochemical disturbance must be significant enough before it affects the Apgar score. The Apgar score alone cannot predict individual neonatal mortality or neurologic outcomes.

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    Limitations Of APGAR Scoring

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    The Apgar score provides a standardized assessment of a newborn's condition immediately after birth, but it has numerous limitations. There are many factors that can influence the Apgar score, including maternal sedation or anesthesia, congenital malformations, gestational age, trauma, and differences in interpretation between caregivers. In addition, a biochemical disturbance must be significant enough before it affects the Apgar score. The Apgar score alone cannot predict individual neonatal mortality or neurologic outcomes.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    69 views2 pages

    Limitations of APGAR Scoring

    Uploaded by

    Fatima Llana Tolentino
    The Apgar score provides a standardized assessment of a newborn's condition immediately after birth, but it has numerous limitations. There are many factors that can influence the Apgar score, including maternal sedation or anesthesia, congenital malformations, gestational age, trauma, and differences in interpretation between caregivers. In addition, a biochemical disturbance must be significant enough before it affects the Apgar score. The Apgar score alone cannot predict individual neonatal mortality or neurologic outcomes.

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    Limitations of the Apgar ScoreLimitations of the Apgar Score

    •The Apgar score is an expression of the infant’s physiologic condition at one point in time, which
    includes subjective components.

    •There are numerous factors that can influence the Apgar score, including maternal sedation or
    anesthesia, congenital malformations, gestational age, trauma, and interobserver variability.

    •The biochemical disturbance must be significant before the score is affected. Elements of the score
    such as tone, color, and reflex irritability can be subjective, and partially depend on the physiologic
    maturity of the infant.

    Putting the Apgar score into perspective

    “The Apgar score alone cannot be considered to be evidence of or a consequence of asphyxia, does not
    predict individual neonatal mortality or neurologic outcome, and should not be used for that purpose.”
    -The American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists
    (ACOG)

    Limitations of the Apgar Score

    There are numerous factors that can influence the Apgar score, including maternal sedation or
    anesthesia, congenital malformations, gestational age, trauma, and interobserver variability.

    In addition, the biochemical disturbance must be significant before the score is affected.

    Conclusions

    The Apgar score describes the condition of the newborn infant immediately after birth and, when
    properly applied, is a tool for standardized assessment.

    It also provides a mechanism to record fetal-to-neonatal transition.


    Apgar scores do not predict individual mortality or adverse neurologic outcome. However, based on
    population studies, Apgar scores of less than 5 at 5 and 10 minutes clearly confer an increased relative
    risk of cerebral palsy, and the degree of abnormality correlates with the risk of cerebral palsy.

    Most infants with low Apgar scores, however, will not develop cerebral palsy.

    The Apgar score is affected by many factors, including gestational age, maternal medications,
    resuscitation, and cardiorespiratory and neurologic conditions.

    Elements of the score, such as tone, color, and reflex irritability, can be subjective and partially depend
    on the physiologic maturity of the infant.

    The score may also be affected by variations in normal transition.

    If the Apgar score at 5 minutes is 7 or greater, it is unlikely that peripartum hypoxia–ischemia caused
    neonatal encephalopathy.

    Monitoring of low Apgar scores from a delivery service may be useful.

    Individual case reviews can identify needs for focused educational programs and improvement in
    systems of perinatal care.

    Analyzing trends allows for the assessment of the effect of quality improvement interventions.

    Sources: https://pediatrics.aappublications.org/content/136/4/819

    https://utswmed.org/medblog/apgar-score/

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