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December 14, 1964


JAMA. 1964;190(11):1006. doi:10.1001/jama.1964.03070240052017

In 1952, Virginia Apgar devised a scoring system whereby the prognosis for a newborn infant during the neonatal period could be estimated.1

Her system, adopted by many centers, rated the newborn according to five objective signs: heart rate, respiratory effort, reflex irritability, muscle tone, and color. A rating of 0, 1, or 2 was given to each sign, depending on whether it was absent or present within one minute after birth. For example, a heart rate of 100 to 140 was given a score of 2; a rate of under 100 received a score of 1; and if no beat could be seen, felt, or heard, the score was 0. Likewise, an infant who cried lustily within one minute after birth was rated 2 in the respiratory category, whereas one which was apneic received a zero; all other types of respiratory effort were scored as 1. The highest possible

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