Abstract
The Apgar score has made a major contribution to neonatal assessment, but are all parts of it equally useful ? In a survey of 436 babies, heart-rate and reflex irritability were found to be best associated with two non-Apgar measures of a baby's state—namely, time to first breath and time to first cry. Heart-rate with time to first breath or time to first cry and time to first cry only were then used in simplified scoring systems on 3 or 4 point scales in place of the 10 in the Apgar score. It seems that a score, based on heart-rate and time to first cry, would simplify the midwife's work without impairing the efficiency of neonatal scoring as a warning for action.
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