Do we assess ‘colour’ appropriately using the Apgar score?

Abstract 

The Apgar score is a useful tool which has been used to assess newborn infants' apparent health within midwifery practice. However, the ‘colour’ sign/observation used as part of the Apgar score requires a review because it is not applied appropriately with regard to the physiological changes that occur from fetal to neonatal life. With regards to this, midwives would usually provide a score of 9/10 at 1min, which suggests that the infant is not entirely healthy because of the categories provided within the Apgar tool. Hence, the physiology from fetal to neonatal life is not understood clearly enough, nor appropriately represented in the Apgar, to reflect the health status of a well newborn infant. More accurate information is required to correctly assess the healthy infant and reassure the parents that an Apgar of 10/10 at 1min is indicative of a normal, well neonate. The assessment of ‘colour’ must also extend to include accurate assessment of all healthy infants, which include those infants born to black African/Caribbean and Asian parents.

Keywords: Neonatal assessment, Fetal physiology, Apgar score/colour, Centrally pink/evenly brown, Normal health neonate