Inventor of the Apgar score for newborn
Virginia Apgar was an American physician, obstetrical anesthesiologist and medical researcher, best known as the inventor of the Apgar score, a way to quickly assess the health of a newborn child immediately after birth in order to combat infant mortality. In 1952, she developed the 10-point Apgar score to assist physicians and nurses in assessing the status of newborns. Given at one minute and five minutes after birth, the Apgar test measures a child’s breathing, skin color, reflexes, motion, and heart rate. A friend said, « She probably did more than any other physician to bring the problem of birth defects out of back rooms. » She was a leader in the fields of anesthesiology and teratology, and introduced obstetrical considerations to the established field of neonatology.
Early life and education
The youngest of three children, Apgar was born and raised in Westfield, New Jersey, the daughter of Helen May (Clarke) and Charles Emory Apgar. She graduated from Westfield High School in 1925, knowing that she wanted to be a doctor from a young age.
Apgar graduated from Mount Holyoke College in 1929, where she studied zoology with minors in physiology and chemistry. In 1933, she graduated fourth in her class from Columbia University College of Physicians and Surgeons (P&S) and completed a residency in surgery at P&S in 1937.
Work and research
Apgar was the first woman to head a specialty division at Columbia-Presbyterian Medical Center (now NewYork–Presbyterian Hospital) and Columbia University College of Physicians and Surgeons. In conjunction with Allen Whipple, she started P&S’s anesthesia division. She was placed in charge of the division’s administrative duties and was also tasked with co-ordinating the staffing of the division and its work throughout the hospital. Throughout much of the 1940s, she was an administrator, teacher, recruiter, coordinator and practicing physician.
In 1949, Apgar became the first woman to become a full professor at P&S, where she remained until 1959. During this time, she also did clinical and research work at the affiliated Sloane Hospital for Women, still a division of NewYork–Presbyterian Hospital. In 1953, she introduced the first test, called the Apgar score, to assess the health of newborn babies.
Between the 1930s and the 1950s, the United States infant mortality rate decreased, but the number of infant deaths within the first 24 hours after birth remained constant. Apgar noticed this trend and began to investigate methods for decreasing the infant mortality rate specifically within the first 24 hours of the infant’s life. As an obstetric anesthesiologist, Apgar was able to document trends that could distinguish healthy infants from infants in trouble.
This investigation led to a standardized scoring system used to assess a newborn’s health after birth, with the result referred to as the newborn’s « Apgar score« . Each newborn is given a score of 0, 1 or 2 (a score of 2 meaning the newborn is in optimal condition, 0 being in distress) in each of the following categories: heart rate, respiration, color, muscle tone and reflex irritability. Compiled scores for each newborn can range between 0 and 10, with 10 being the best possible condition for a newborn. The scores were to be given to a newborn one minute after birth, and additional scores could be given in five-minute increments to guide treatment if the newborn’s condition did not sufficiently improve. By the 1960s, many hospitals in the United States were using the Apgar score consistently. In the 21st century, the score continues to be used to provide an accepted and convenient method for reporting the status of the newborn infant immediately after birth.
Legacy
Apgar has continued to earn posthumous recognition for her contributions and achievements. In 1994, she was honored by the United States Postal Service with a 20¢ Great Americans seriespostage stamp. In November 1995, she was inducted into the National Women’s Hall of Fame in Seneca Falls, New York. In 1999, she was designated a Women’s History Month Honoree by the National Women’s History Project. On June 7, 2018, Google celebrated Apgar’s 109th birthday with a Google Doodle.
