The Apgar Score in the 21st Century

In 1952, Dr. Virginia Apgar developed a scoring system to evaluate the condition of neonates born at the Sloane Hospital for Women in New York City.1 Dr. Apgar, an obstetrical anesthesiologist, intended that her scoring system be used to assess the effect of obstetrical practices on the clinical condition of neonates immediately after birth. Her simple system was based on a sum of five numbers obtained 60 seconds after birth. The numbers were determined by objective observations of five signs that were traditionally used by anesthesiologists to monitor a patient's condition throughout surgery (heart rate, respiratory effort, reflex irritability, muscle . . .