Editing Apgar score (section)

=== Limitations ===
There are numerous factors that contribute to the Apgar score, several of which are subjective. Examples of subjective factors include but are not limited to color, tone, and reflex irritability.<ref>{{Cite web |title=Apgar score: MedlinePlus Medical Encyclopedia |url=https://medlineplus.gov/ency/article/003402.htm |access-date=2022-11-18 |website=medlineplus.gov |language=en}}</ref> Preterm infants may receive a lower score in these categories due to lack of maturity rather than asphyxia. Other factors that may contribute to variability among infants are birth defects, sedation of the mother during labor, gestational age or trauma. Inappropriately using the Apgar score has led to errors in diagnosing asphyxia.<ref name=":0" />

Various studies have shown that the Apgar score has variability between individual medical providers. One study was done in which several health care providers were assigned to give Apgar scores to the same infants. Results showed an Apgar score consistency of 55% to 82% between health care providers.<ref name=":1">{{Cite journal|last=Montgomery|first=Kristen S.|date=2000|title=Apgar Scores: Examining the Long-term Significance|journal=The Journal of Perinatal Education|volume=9|issue=3|pages=5–9|doi=10.1624/105812400X87716|issn=1058-1243|pmc=1595023|pmid=17273212}}</ref><ref>{{Cite journal|last=Livingston|first=Jacquelynn|date=1990-11-01|title=Interrater reliability of the apgar score in term and premature infants|journal=Applied Nursing Research|volume=3|issue=4|pages=164–165|doi=10.1016/S0897-1897(05)80139-9|pmid=2252404|issn=0897-1897}}</ref> Ideally, to limit variability and bolster consistency, it is preferred that the same individual determine the 1-minute and 5-minute Apgar scores.<ref name=":5" />

A 2023 paper of nine million babies, found that non-white babies were given lower Apgar scores than white babies, as their darker skin color often results in lower scores on the appearance measure, making them more likely to receive medical care that might not be needed.<ref>Rabin, Roni Caryn. [https://www.nytimes.com/2024/07/13/health/apgar-score-black-infants.html "Why Does a Routine Test of Newborns Reward 'Pink' Skin? The Apgar test grades infants in five areas, including skin tone. Babies of color score lower, and may be subjected to unnecessary treatment."], ''[[The New York Times]]'', July 15, 2024. Accessed July 16, 2024. "Dr. Grünebaum led a study that analyzed the Apgar scores of more than nine million American babies born between 2016 and 2019. Overall, he found, only 2.6 percent of newborns got a perfect score. But the odds for a Black baby to do so were less than half those of a white infant: 3.3 percent of white babies scored a perfect 10, compared with 1.4 percent of Black newborns, the study found.... But critics of the Apgar score’s reliance on skin color fear that it is resulting in extra medical treatment being heaped on babies of color who are healthy, potentially sending them to intensive care unnecessarily."</ref>