A New Use for Apgar’s: Low Apgar Scores and Maternal Health

An Apgar score is the very first test given to a newborn. It is a quick evaluation tool used by a medical practitioner, often an obstetrician or obstetrical nurse, to assess how well the newborn tolerated the delivery and whether or not the neonate requires immediate medical care.

This tool has been employed since 1952 when it was developed by the Anesthesiologist, Dr. Virginia Apgar. Often it’s referred to as an acronym for the following five factors: Appearance (skin colour), Pulse (heart Rate), Grimace (reflex response), Activity (muscle tone), and Respiration (breathing rate and effort). Each of these factors is evaluated and scored on a scale from 0 (none) to 2 (normal) out of a total of 10. The evaluation is usually conducted at one and five minutes after birth. Most newborns score between 7 and 10. A low Apgar score can be an indication for intervention and monitoring. Persistently low Apgar scores can be associated with long-term developmental issues, such as cerebral palsy.

Since the evaluation’s inception its application was limited to identify whether newborns needed urgent medical care or emergency measures. Interestingly, a recent six-year study of over 600,000 Ontario singleton baby health records, has extended the application of this evaluation tool. The study, published in JAMA Pediatrics titled “Association of Newborn Apgar Score With Maternal Admission to the Intensive Care Unit” has identified a link between the newborn’s Apgar score and the mother’s need for critical care. The study shows that the lower the Apgar score the higher the rate of mother’s admission to the ICU. For example, a normal newborn Apgar score resulted in 1.7 maternal ICU admissions per thousand but a low rage Apgar score resulted in an increase to 18.2 maternal ICU admissions per thousand.

A mother’s need for critical care is not always identifiable. Birth is a time of great excitement and young healthy women often have physical reserves that could prevent maternal vital signs from signaling concern after birth. It is likely that this rings true even more so in situations where the newborn has low Apgar scores and must undergo emergency intervention. Thus, the novel application of this universally accepted metric shows far-reaching potential to positively impact maternal health by ensuring practitioners are extra-mindful of the mother’s condition when their newborn presents with abnormal Apgar scores.

Disclaimer and Liability Exclusion

The information on this page is provided for general information purposes only. It should not be construed as legal advice. It does not constitute legal or other professional advice or an opinion of any kind. Readers should seek specific legal advice regarding any specific legal issues. We do not in any way guarantee or warrant the accuracy, completeness or quality of the information on this page. The posts on this page are current as of their original date of publication, but they should not be relied upon as timely, accurate or fit for any particular purpose.

Accessing or using this web site or the content herein does not create a lawyer-client relationship.

This page may contain links to third party web sites. We are unable to, and do not, monitor and guarantee the quality of the information disseminated and accessible through those links, which are provided for convenience only. We do not endorse the information contained in linked web sites nor guarantee its accuracy, timeliness or fitness for a particular purpose.

If you have been affected by medical malpractice anywhere in Canada contact us for a free consultation.
You pay us nothing unless we win.



Please provide us a summary of your case. A lawyer from Sommers Roth & Elmaleh will be in touch with you as soon as possible. Please note that no lawyer-client, advisory, or fiduciary relationship is created by your inquiry.

The above information is not legal advice. Past results of cases and recoveries by our medical malpractice lawyers against hospitals, doctors, midwives, nurses and other healthcare professionals are not necessarily indicative of future results. The amounts recovered and other litigation outcomes will vary according to the facts in individual cases.