Which parameter is NOT included in the APGAR scoring?

• A. Blood pressure
• B. Heart rate
• C. Respiratory effort
• D. Color

Answer: (A)

APGAR scoring evaluates how well a newborn is adapting right after birth by five quick observations. Blood pressure isn’t part of this assessment; the five domains it uses are heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each domain is scored 0, 1, or 2, giving a total possible score from 0 to 10. Heart rate is a core component, with a heart rate above 100 bpm earning the highest score, while absent or very slow heart rate lowers the score. Respiratory effort looks at the newborn’s breathing pattern and crying. Color assesses skin coloration, with pink skin yielding higher scores than partial or central cyanosis. Reflex irritability measures the response to stimulation, and muscle tone evaluates limb movement and resistance to extension. Since blood pressure isn’t measured in this quick bedside assessment, it does not contribute to the APGAR total.