Q&A: What problems can be associated with a low Apgar score?
My baby had a one-minute APGAR score of 1 and a five-minute APGAR score of 9. She has had frequent infections and gastric reflux for her first six months. Are these problems related to the low initial APGAR score?
To answer your question, I think it will be most helpful to explain what Apgar scores are, how they are determined, and what they can (and can’t) tell us. The Apgar score was designed and is used to help determine which newborns need extra medical attention and care. Scores are typically given at one and five minutes after birth as a quick and general way to assess newborns’ overall well-being and (when necessary) their response to resuscitation. These scores are based on five different factors: activity level (muscle tone), heart rate, breathing, grimace/cry (also referred to as reflex irritability and an indicator of responsiveness), and appearance of the skin. For each of these factors, newborns are given a score of 0, 1, or 2, making the highest score possible a 10. <
That said, it’s worth noting that scores can be somewhat subjective and can definitely be influenced by lots of things, including medications, trauma, infection, and prematurity (to name but a few). They can also be very inter-related such that a low score in one category can result in low scores in the others. A baby who is slow to start breathing on his or her own, for example, is more likely to also have a slow heart rate, look a bit blue, be a bit floppy, and be less responsive until his/her breathing kicks in—resulting not only in a low (0 or 1) score for breathing, but for all the other categories as well. To more specifically address the scenario like what you experienced where a baby receives a low one-minute score followed by a normal five-minute score (considered to be anywhere from 7 to 10), let me also point out that the importance of a low one-minute Apgar has not been shown to correlate with poor future outcomes.
Having said all that, you can hopefully better understand that a baby’s Apgar scores alone (especially when the five-minute score is absolutely normal) don’t serve as useful predictors of future infections or the presence of gastric reflux—two very common occurrences that unfortunately afflict lots of babies during their first year, irregardless of their newborn Apgar scores.