This is a scoring system for the evaluation of newborn babies developed by Dr. Virginia Apgar in 1953. A score of 0, 1, or 2 is given to five vital signs which are assessed at 1 minute, 5 minutes, and 10 minutes. The five vital signs are : appearance, pulse, reflex, muscle tone, and breathing pattern. The following is how the scores are given: Score Color Heart Rate Reflex Muscle Tone/Activity Respiration 0 blue, pale absent no response limp absent 1 body pink, extremeties blue below 100 grimace some flexion of extremeties slow, irregular 2 completely pink over 100 cough, sneeze, cry active good, crying It is fair to say that APGAR score at 1 minute after birth reflects the neonate's need for attention. A low 1 minute score is not necessarily indicative of any long term problems of the baby (a normal premature child would have a low score, as might the baby of a woman under heavy analgesia). The five minutes score is a reflection of the success of effectiveness of the resuscitation. Neither are the 1 minute or 5 minute scores good indicators of future problems or performances of the child. A low Apgar score at 10 minutes and after may indicate problems, such as cerebral palsy, especially if other clinical signs are present (e.g. hypotonia, seizures, metabolic acidosis)