We recently did a talk regarding APGAR scoring. Following that talk, we received questions about how even with “good” APGAR scores, some parents have still seen their baby move to an HIE diagnosis. As a result, in this post we will focus on some limits with APGAR scoring. Hopefully by the end, you will understand that although APGAR scoring can be helpful, it has limitations.

What Are APGAR Scores?

Before talking about the limits with the scoring, lets discuss briefly what are APGAR scores. APGR scores are a test given to newborns immediately following birth. The scoring looks to give a snapshot in time of certain health categories for a baby. Two of the main areas of analysis are heart rate and muscle tone.

The scoring can be done at the 1-minute mark, the 5-minute mark and in some cases the 9- or 10-minute mark. Scoring can be done from 1-10. Generally, a score in the 7, 8, and 9 range means good health. So, if a baby is given a generally “good” score how can that baby reveal a traumatic brain injury later in time?

Limits With APGAR Scoring

One of the main limits with APGAR scoring is that it is not a perfect testing method because the testing process can be subjective as to the medical professional scoring the test. In other words, you can have the same baby assessed by multiple nurses and get different scoring based on each individual nurses’ assessment.

Second, remember that APGAR scores are a snapshot in time of that specific picture. At that moment it might seem that a baby is fine but during labor and delivery oxygen deprivation occurred. Remember, for some babies who suffer an HIE injury, their reduction in blood and oxygen occurs as a partial prolonged event, or it can be an acute or asphyxia event. These things could have occurred earlier and by the time the baby is born, the injury has already happened, but the baby presents well enough for “good” APGAR scores.

Thanks for reading from your friends at HIE Resource Place.