Clinical commentary
Apgar scores are clinical indicators of a baby’s condition shortly after birth. The 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 (AIHW 2021).
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 complications for the baby (AIHW 2021). Between 2004 and 2019 there has been a noticeable 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).