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Further Observations on the Newborn Scoring System

V. APGAR, M.D., M.P.H.; L. S. JAMES, M.D.
Am J Dis Child. 1962;104(4):419-428. doi:10.1001/archpedi.1962.02080030421015.
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The need for a simple method whereby the newborn's condition could be rapidly evaluated was the main reason for developing a scoring system. Breathing and crying times were not satisfactory criteria, many quite severely depressed infants being treated with nothing but watchful waiting, while others who were comparatively healthy received unnecessary oxygen and manipulation.

After a 3-year period of preparatory observations at the Sloane Hospital for Women, the scoring system was first introduced in 1952.1 it is based on 5 objective signs: heart rate, respiratory effort, muscle tone, reflex irritability, and color, judged 60 seconds after delivery. This particular time interval was chosen since, on the average, it coincided with maximal depression in our clinic.

The present paper summarizes our experience of 8 years between 1952 and 1960 and considers some other applications of the system.

Predictive Value for Survival of Premature and Full-Term Infants.—It was noted previously


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