# Apgar Score Calculator

> Sums the five Apgar components (appearance, pulse, grimace, activity, respiration), each scored 0–2, into the 0–10 newborn score and reports the AAP/ACOG interpretation band (7–10 reassuring, 4–6 moderately abnormal, 0–3 low).

- Calculator id: `apgar-score` · Category: Medical & Clinical (`medical`) · Tool name: `calculate_apgar_score`
- Canonical page: https://tttkmbb.com/medical/apgar-score · This document: https://tttkmbb.com/medical/apgar-score.md · JSON definition: https://tttkmbb.com/medical/apgar-score.json

## Purpose

Sums the five Apgar components (appearance, pulse, grimace, activity, respiration), each scored 0–2, into the 0–10 newborn score and reports the AAP/ACOG interpretation band (7–10 reassuring, 4–6 moderately abnormal, 0–3 low).

**Use when:** You have the five observations of a newborn at 1, 5 or 10 minutes after birth and need the total Apgar score and its band.

**Do not use when:** You need to predict an individual infant's outcome or decide on resuscitation (the score does not direct resuscitation, which starts before the 1-minute score); results are informational and not medical advice.

## Input

| Parameter | Type | Unit | Required | Description |
| --- | --- | --- | --- | --- |
| `appearance` | enum: blue_pale \| body_pink_extremities_blue \| completely_pink |  | required | Skin colour: blue_pale = 0, body_pink_extremities_blue = 1, completely_pink = 2. |
| `pulse` | enum: absent \| below_100 \| above_100 |  | required | Heart rate: absent = 0, below_100 = 1, above_100 = 2. |
| `grimace` | enum: no_response \| grimace \| cry_or_cough |  | required | Response to stimulation: no_response = 0, grimace = 1, cry_or_cough = 2. |
| `activity` | enum: limp \| some_flexion \| active_motion |  | required | Muscle tone: limp = 0, some_flexion = 1, active_motion = 2. |
| `respiration` | enum: absent \| weak_irregular \| strong_cry |  | required | Breathing effort: absent = 0, weak_irregular = 1, strong_cry = 2. |

## Output

| Field | Type | Unit | Description |
| --- | --- | --- | --- |
| `apgar_score` | integer |  | Sum of the five components, 0–10. |
| `interpretation` | string |  | AAP/ACOG 2015 bands: 7–10 reassuring, 4–6 moderately abnormal, 0–3 low. |
| `component_scores` | object |  | Points for appearance, pulse, grimace, activity and respiration. |
| `note` | string |  | Timing of the score and what it does and does not indicate. |

## Formula

`apgar_score = appearance + pulse + grimace + activity + respiration, each 0, 1 or 2; 7–10 reassuring, 4–6 moderately abnormal, 0–3 low`

Virginia Apgar's 1953 score with the interpretation bands of the 2015 AAP/ACOG Committee Opinion 644, which also notes that the score reflects prematurity, maternal medication and congenital conditions and is not evidence of asphyxia by itself. Results are informational only and not a substitute for clinical judgement or medical advice.

## Data Sources

- AAP/ACOG Committee Opinion No. 644 (2015) The Apgar Score — https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/10/the-apgar-score (standard, retrieved 2026-09-24)
- Apgar V (1953) A proposal for a new method of evaluation of the newborn infant, Curr Res Anesth Analg 32:260-267 — https://pubmed.ncbi.nlm.nih.gov/13083014/ (peer_reviewed, retrieved 2026-09-24)

Data freshness: `static`. Deterministic formula with fixed constants; results never go stale. Inputs supplied by the caller determine the output.

## API

- `GET https://tttkmbb.com/api/v1/calculate/apgar-score?appearance=…&pulse=…&grimace=…&activity=…&respiration=…`
- `POST https://tttkmbb.com/api/v1/calculate/apgar-score` with JSON body `{"inputs": {…}}`
- Response: unified envelope (`success`, `request`, `result.values`, `result.units`, `sources`, `freshness`, `timestamp`, `next_actions`, `links`); see https://tttkmbb.com/docs/response-format.md
- Schema: https://tttkmbb.com/api/v1/calculators/apgar-score · OpenAPI operationId `calculate_apgar_score` in https://tttkmbb.com/openapi.json
- Authentication: none. Rate limit: fair use, see https://tttkmbb.com/docs/rate-limits.md.

## MCP

- Server: `https://tttkmbb.com/mcp` (Streamable HTTP, JSON-RPC 2.0, no auth)
- Tool:  `run_calculator` with `{"calculator_id": "apgar-score", "inputs": {…}}`

## Example

- Pink, pulse >100, grimace, active, strong cry: inputs `{"appearance":"completely_pink","pulse":"above_100","grimace":"grimace","activity":"active_motion","respiration":"strong_cry"}` → `{"apgar_score":9,"interpretation":"Reassuring (7–10)","component_scores":{"appearance":2,"pulse":2,"grimace":1,"activity":2,"respiration":2}}`
- Blue, pulse <100, no response, limp, weak breathing: inputs `{"appearance":"blue_pale","pulse":"below_100","grimace":"no_response","activity":"limp","respiration":"weak_irregular"}` → `{"apgar_score":2,"interpretation":"Low (0–3)"}`

```
GET https://tttkmbb.com/api/v1/calculate/apgar-score?appearance=completely_pink&pulse=above_100&grimace=grimace&activity=active_motion&respiration=strong_cry
```

## Limitations

You need to predict an individual infant's outcome or decide on resuscitation (the score does not direct resuscitation, which starts before the 1-minute score); results are informational and not medical advice. Virginia Apgar's 1953 score with the interpretation bands of the 2015 AAP/ACOG Committee Opinion 644, which also notes that the score reflects prematurity, maternal medication and congenital conditions and is not evidence of asphyxia by itself. Results are informational only and not a substitute for clinical judgement or medical advice. All values are computed from the formula above; no measurement or live data is involved.

## FAQ

**When is the score assigned?**

At 1 and 5 minutes after birth; if the 5-minute score is below 7, every 5 minutes up to 20 minutes. Resuscitation, when needed, begins before the 1-minute score.

**Does a low score mean brain injury?**

No. A 5-minute score of 0–3 is associated with higher neonatal mortality at population level, but the score alone does not predict an individual infant's neurological outcome and is not evidence of asphyxia.

**Is the score valid in preterm infants?**

Tone and reflex responses are lower in healthy preterm infants, so scores are lower without illness; the bands were described for term and late-preterm infants.

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