Apgar results depend on tester

by Kristin Darguzas (Subscribe to Kristin Darguzas's posts) Nov 2nd 2006 9:30AM

I read a lot about the Apgar tests for newborn babies when I was pregnant. During my pregnancy, I liked to obsess over the various scenarios that might or might not happen when my son was born. I figured the more I knew, the more prepared I'd be for impending disaster, but really I was just giving myself ulcers and grey hair.

The Apgar score was developed by anesthesiologist Dr. Virgina Apgar in 1953, and rates a newborn infant's respiration, muscle tone, heart rate, reflexes, and skin colour on a scale of one to ten. I was told - though I'm not entirely sure it's true - that no baby is ever afforded a perfect ten.

After Nolan had been cut out of me, and I was numb from the neck down and chattering violently from the drugs, my first question was "What's his Apgar score?" I think someone muttered nine, but I'm not fully sure. It didn't matter, they took him away anyway to test for diabetes due to his size.

It turns out that it's probably an arbitrary number anyway. A recent study found that Apgar scores vary wildly according to who conducts them. The implication of the study is that "more objective measures", the lead researcher said.

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JustMe 11-02-2006 @ 1:22PM

I read that the Apgar test was originally developed because some doctors would let some babies who just didn't look "good" die. Apgar came up with the test as a way of more objectively deciding which babies should be saved.

http://www.newyorker.com/printables/fact/061009fa_fact

"Throughout her career, the work she loved most was providing anesthesia for child deliveries. But she was appalled by the poor care that many newborns received. Babies who were born malformed or too small or just blue and not breathing well were listed as stillborn, placed out of sight, and left to die. They were believed to be too sick to live. Apgar believed otherwise, but she had no authority to challenge the conventions. She was not an obstetrician, and she was a female in a male world. So she took a less direct, but ultimately more powerful, approach: she devised a score.

"The Apgar score, as it became known universally, allowed nurses to rate the condition of babies at birth on a scale from zero to ten. An infant got two points if it was pink all over, two for crying, two for taking good, vigorous breaths, two for moving all four limbs, and two if its heart rate was over a hundred. Ten points meant a child born in perfect condition. Four points or less meant a blue, limp baby.

"The score was published in 1953, and it transformed child delivery. It turned an intangible and impressionistic clinical concept—the condition of a newly born baby—into a number that people could collect and compare. Using it required observation and documentation of the true condition of every baby. Moreover, even if only because doctors are competitive, it drove them to want to produce better scores—and therefore better outcomes—for the newborns they delivered."

So, it may be imperfect, but it is certainly better than the alternative when it was invented!

Tamyu 11-02-2006 @ 11:44PM

Some babies do indeed get 10.
I know my sister and brother both did - I was actually present for my brother`s birth so got to hear it first hand. As for me, I only got a 9.

My son had a 2. Hahahaha....