Apgar score of less than 7 at 5 minutes for birth at or after term

Apgar scores are clinical indicators of a baby’s condition shortly after birth, with a score of less than 7 indicating potential complications for the baby. For more information, see Clinical commentary.

This indicator examines those babies born with an Apgar score of less than 7 at 5 minutes for births at or after term (37 weeks of gestation or more).

Key findings

  • There has been a small increase in the number of babies born at or after term with an Apgar score of less than 7 at 5 minutes, from 0.9% in 2004 to 1.3% in 2020.
  • Babies born to mothers younger than 20 were most likely to have an Apgar score of less than 7 at 5 minutes and, in 2020, the proportion born to this youngest age group was almost 2 times higher (2.2%) than those born to women aged 30 to 34 (1.2%).

The interactive data visualisation below presents data for births at or after term with an Apgar score of less than 7 at 5 minutes by selected maternal characteristics. Click the Data tables button to view the data between 2004 and 2020 and use the radio buttons to see how each characteristic has changed during this time.

Apgar score of less than 7 at 5 minutes for births at or after term, by State/territory of birth and all Australia, 2004 to 2020.

This chart shows the proportion of babies with an Apgar score of less than 7 at 5 minutes for births at or after term, by state/territory of birth, 2004 to 2020.  Data can be viewed for each state/territory of birth, and for all Australia. The proportion of babies with an Apgar score of less than 7 at 5 minutes for births at or after term, for all Australia showed a gradually increasing trend from 0.9% in 2004, peaking at 1.4% in 2016, with rates stabilising at 1.3% in all years since then.

Clinical commentary

An Apgar score is based on five characteristics of the baby: skin colour, pulse, breathing, muscle tone and reflex irritability. Each characteristic is given between 0 and 2 points, with a total score between 0 and 10 points. An Apgar score of 7 or more at 5 minutes after birth indicates the baby is adapting well to the environment, while a score of less than 7 indicates an increased risk of complications for the baby (AIHW 2022). Between 2004 and 2020 there has been a small increase in the incidence of babies born at or after term with an Apgar score less than 7 at 5 minutes. The cause of this change is not clear.

Apgar scores at 5 minutes of less than 7 are not specific to any condition and may reflect congenital anomaly, prematurity, perinatal infection, effects of drugs given to the mother for pain relief or anaesthesia, ineffective resuscitation or prolonged hypoxia before birth (Li et al. 2013).  Maternal factors such as increased maternal age, obesity, maternal morbidity, especially diabetes, and maternal smoking during pregnancy, may contribute to a baby being born with a low Apgar score (Kharkova et al. 2017; Straube et al. 2010; Zhu et al. 2015).

Indicator specifications and data

Excel source data tables are available from the Data tab.

For more information refer to Specifications and notes for analysis in the technical notes.