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During the 1930s and '40s, Dr. Virginia Apgar noticed a troubling trend involving newborns.
While the infant mortality rate in the US had declined, the rate of infant deaths within the first 24 hours after birth remained constant. As an obstetric anesthesiologist, Apgar was able to identify physical characteristics that could distinguish healthy newborns from those in trouble.
Apgar's observations led to the development in 1952 of the Apgar score, a quick and convenient method for immediately evaluating how well the newborn weathered the birthing process, especially the effects of obstetric anesthesia.
To honor Apgar's contribution to neonatology -- the medical care of newborn infants -- Google dedicated its Doodle Thursday to the doctor on her 109th birthday.
Generally conducted one and five minutes after birth, the test assigns a score of zero to two for each of five criteria: appearance, pulse, grimace, activity and respiration (APGAR). Scores of seven and higher are generally normal, four to six fairly low, and three and lower are generally regarded as critically low. The test helps medical personnel determine whether a newborn needs immediate medical care.
The test spread through US hospitals in the 1960s, proving a useful measurement for quickly assessing a newborn's physical condition. The technique is still used in hospitals throughout the US.
Apgar graduated fourth in her class at Columbia University College of Physicians and Surgeons in 1933, and in 1949 became the first woman named a full professor at the school.
In 1959, she embarked on a second career, earning a master's degree in public health from Johns Hopkins School of Hygiene and Public Health. Armed with her new degree, she went to work at the March of Dimes Foundation, directing research to prevent and treat birth defects.
She also published more than 60 scientific articles and several essays for newspapers and magazines during her career. Her 1972 book Is My Baby All Right? explains the causes and treatment of common birth defects and proposes precautions to help improve the chances of having a healthy baby.
Apgar died at the age of 65 in 1974.
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Thursday’s Google Doodle celebrates the birthday of Dr. Virginia Apgar, whose Apgar Score has saved countless lives. She was born on June 7, 1909.
Dr. Virginia Apgar, who would have been 109 years old today (she died in 1974), was the obstetric anesthetist who developed the Apgar Score test for the health of newborn babies that is still used around the world today.
The Apgar Score’s name is not just that of its creator — each letter refers to a part of the test.
Today’s #GoogleDoodle celebrates obstetrical anesthesiologist Dr. Virginia Apgar, who invented the Apgar score as a way to quickly assess a newborn's health → https://t.co/j7q4rv1yfE pic.twitter.com/FmdsoZNx2E — Google (@Google) June 7, 2018
The Apgar test examines:
Appearance (is the newborn a healthy color or blueish?)
Pulse (is it above or below 100 beats per minute, or undetectable?)
Grimace (what response does the baby make when reflexes are stimulated?)
Activity (how much are legs and arms moving?)
Respiration (how strong is the baby’s breathing?)
JAN 26 1962, 3-13-1962; L to R: James P. Eakins and Virginia Apgar; (Photo By Bill Peters/The Denver Post via Getty Images) Bill Peters Denver Post via Getty Images
The Apgar Score is what’s known as a “backronym” — the words were only chosen after the Dr. Apgar‘s test had gone into practice in 1952, in order to help people remember the elements of the test.
COOL: This morning's @GoogleDoodles honors Virginia Apgar (MPH '59) on what would have been her 109th birthday. As a researcher and maternal and child health advocate, Dr. Apgar developed the 10-point "Apgar Score" used to assess the health of newborns. https://t.co/7OV7sxNT4a pic.twitter.com/YfVMhzsrL1 — JHU Public Health (@JohnsHopkinsSPH) June 7, 2018
Each of these categories in Dr. Apgar’s test earns the baby between zero and two points, depending on the health of the response. The theoretical maximum is 10, but this is rare. An Apgar Score between 4 and 6 may mean some medical intervention is needed. An Apgar Score below four may mean resuscitation is needed. The Apgar test is conducted a minute after birth, and again four minutes later, in order to judge the effectiveness of intervention.
Dr. Apgar developed the test after noticing that, even though the general U.S. infant mortality rate fell between the 1930s and 1950s, it remained constant for babies within the first day of life.
Who was Dr. Virginia Apgar? She developed the Apgar Score, the first standardized method to monitor a baby's health after being born. 👶 Today, the Apgar Score is used throughout the world, and has saved countless lives. https://t.co/UaE1I3eCAf pic.twitter.com/M2LZO9fXuv — HHS.gov (@HHSGov) June 7, 2018
Apart from developing her famous scoring exercise, Dr. Apgar was a notable advocate for universal vaccination in order to combat the rubella epidemic of the mid-Sixties. In her later years, she worked for March of Dimes, a non-profit founded by President Franklin Roosevelt that initially targeted polio but went on to focus on the prevention of birth defects.
Even before she developed the Apgar Score, Dr. Apgar had already become the first female full professor at the Columbia University College of Physicians and Surgeons. She received a master’s degree in public health from Johns Hopkins University in 1959, and was a director at the National Foundation for Infantile Paralysis, which is know known as the March of Dimes.
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American obstetrical anaesthetist Dr Virginia Apgar (1909-1974) was born 109 years ago today.
Google’s latest animated Doodle pays tribute to the creator of the “Apgar score”, the test still used to this day to quickly assess the health of newborn babies.
Her pioneering work in comparing the wellbeing of sickly infants to healthy ones proved crucial to lowering the infant mortality rate in the US and advancing the cause of maternity care.
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Virginia Apgar was born in Westfield, New Jersey, on 7 June 1909 into a family of music lovers, her father an insurance executive by trade but a keen amateur astronomer and inventor.
The death of her elder brother from tuberculosis and the persistent ill health of another brother, Lawrence, inspired her decision to study medicine as a young woman.
Graduating from Mount Holyoke College in Massachusetts in 1929, she studied zoology and minored in physiology and chemistry before finishing fourth in her class at Columbia University College of Physicians and Surgeons in 1933, completing a residency in surgery at the same institution in 1937.
She was discouraged from continuing her career as a surgeon, which was regarded as a very male discipline at that time, and instead trained in anaesthesiology at the University of Wisconsin-Madison under Dr Ralph Waters, who had established the country’s first dedicated unit. After further study of the field at New York’s Bellevue Hospital, she returned to Columbia as director of its new anaesthesia division, its first female head of department.
Building the unit from the ground up in partnership with her old mentor Dr Allen Whipple (who had steered her away from surgery), Dr Apgar worked tireless as both a practising physician and administrator, no easy task when America’s entry into the Second World War in 1941 created significant staffing shortages.
Dr Apgar developed her five-point score for assessing newborn health in 1952. The test grades babies on scores of zero to two on five key criteria: the colour of their skin, their pulse rate, their reflex ability, their responsiveness to limb flexion and their respiratory rate. The resulting scores are totted up to give a total out of 10 indicating the health or otherwise of the infant in question.
The criteria can be remembered by the acronym ”Apgar”, standing for Appearance, Pulse, Grimace, Activity, Respiration.
In 1959, by which point her test had been rolled out across US maternity hospitals, Dr Apgar left the Columbia-Presbyterian Medical Center to earn a Master of Public Health degree from the Johns Hopkins School of Hygiene and Public Health and served as vice president for medical affairs at the March of Dimes Foundation to advance the study of birth defects.
She was an outspoken advocate for universal vaccinations to prevent mother-to-child transmission of rubella during the pandemic that struck 12.5m people in the US between 1964-65 and contributed more than 60 articles to newspapers, magazines and academic journals, publishing her book Is My Baby All Right? with Joan Beck in 1973.
Dr Apgar was known throughout her career for her warm bedside manner and forthright optimism. In her personal life, she played the violin, enjoyed a range of hobbies from fly-fishing and stamp collecting and took flying lessons, dreaming of swooping under the George Washington Bridge.
Although she rarely campaigned against or spoke publicly about gender inequalities, Dr Virginia Apgar glided past the sexism of her period with ease, preferring instead to lead by example and allow her professional excellence and commitment to her work speak for itself.
