Newborn examination schedule and interpretation of Apgar scores
THE CONTEXT
Newborn assessment requires repeated physical examination because findings can change over time. Apgar scoring describes early cardiopulmonary status and adaptation after birth.
Physical examination
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Most neonates are healthy; about 10% are sick and small and require neonatal-unit admission for observation or treatment.
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Examine the newborn soon after birth, at 24 hours, before discharge, and at the follow-up visit because physical findings may differ at different time points.
Apgar timing and significance
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Assign Apgar scores at 1 and 5 minutes. If the score is below 7, repeat scoring every 5 minutes until 20 minutes.
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The Apgar score provides information about cardiopulmonary status at birth and adaptation to the postnatal environment.
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A score of 0–3 at 5 minutes correlates with mortality, but low Apgar scores do not predict long-term neurodevelopmental outcomes.