Apgar Scores less than 7 at 5 Minutes for Term Newborns by Maternal Characteristics

As per the American College of Obstetricians and Gynecologists and American Academy of Pediatrics (2014,2015), for the term or late preterm infant, a 5-minute Apgar score of 7 to 10 is reassuring, a score of 4 to 6 is moderately abnormal, and a score of 0 to 3 is low. The American Academy of Pediatrics and the American Heart Association (Weiner & Zaichkin, 2021) estimate that 10% of newborns at term require resuscitation at birth, which is in part based on their assessment via Apgar scoring. Data on Apgar scores at birth are often generated as secondary study outcomes rather than the main research focus. Apgar scores at 5 minutes of life for term infants in the United States for selected populations are presented from 2024 certificates of live birth from the Centers for Disease Control and Prevention and National Center for Health Statistics (2025) National Vital Statistics System, Provisional Natality on CDC WONDER Online Database. Term Births: In 2024, there were 3,618,267 births, of which 3,237,151 (89.5%) were at term (37 completed weeks of gestation or more; including early term [37 weeks and 0 days through 38 weeks and 6 days], full term [39 weeks and 0 days through 40 weeks and 6 days], late term [41 weeks and 0 days through 41 weeks and 6 days], and post term [greater than or equal to 42 weeks and 0 days]). Route of Birth: For term births, 2,268,347 (70.1%) were vaginal and 966,670 (29.9%) were via cesarean. Among term births, 48.813 (1.5%) had 5-minute Apgar scores less than 7; (26,562, 1.2% for vaginal births) and (22,223, 2.3% for cesarean births). Induction of Labor: Among term births, there were 1,147,007 (35.5%) labor inductions. Of term infants born after labor induction, 20,552 (1.8%) had 5-minute Apgar scores less than 7 and of 2,088,654 term infants whose mothers did not have labor induction, 28,234 (1.4%) had 5-minute Apgar scores less than 7. Gestational Hypertension: Gestational hypertension (pregnancy-induced hypertension + preeclampsia) complicated 299,070 (9.2%) births at term. Among women at term with gestational hypertension, 7,289 (2.4%) had 5-minute Apgar scores less than 7 and of 2,291,341 women term without gestational hypertension, 41,434 (1.8%) had 5-minute Apgar scores less than 7. Gestational Diabetes: Gestational diabetes complicated 264,042 (8.2%) of births at term. Among women at term with gestational diabetes, 4,670 (1.7%) had 5-minute Apgar scores less than 7 and of 2,969,225 women at term without gestational diabetes, 44,053 (1.5%) had 5-minute Apgar scores less than 7. Gestational Hypertension and Gestational Diabetes: There were 37,067 (1.2%) births at term complicated with both gestational hypertension and gestational diabetes. Of those, 986 (2.7%) had Apgar scores less than 7 at 5 minutes. Apgar scores less than 7 at 5 minutes of life for term infants are unusual but require updated knowledge and skill from the nurse assigned to the baby at birth and the other members of the neonatal resuscitation team (Association of Women's Health, Obstetric and Neonatal Nurses, 2022,2024).