This week, our Hero of Progress is Virginia Apgar, an American anesthesiologist and medical researcher who created a test that is used to quickly assess the health of newborn babies and to determine whether infants need immediate neonatal medical care. The test, which is named the "Apgar Score" continues to be used as a standard practice across the world and it is credited with saving the lives of millions of babies since 1952.
Virginia Apgar was born in Westfield, New Jersey, on June 7, 1909. Apgar had two older brothers, one of whom died at a young age due to tuberculosis, while the other lived with a chronic illness. Inspired by both of her brothers’ medical problems, Apgar opted for a career in the medical industry. In 1929, Apgar earned a degree in zoology with minors in physiology and chemistry from Mount Holyoke College, and in the same year, she began her medical training at Columbia University’s College of Physicians and Surgeons (P&S).
Professorship in anesthesiology freed Apgar from many administrative duties, thus enabling her to devote more of her time to research.
Apgar obtained her MD in 1933 and began a two-year surgical internship at P&S’s Presbyterian Hospital. In spite of her good performance, P&S’s chairman, who was worried about economic prospects of new women surgeons during the Great Depression, advised Apgar to make a career in anesthesiology—a new field of study that was beginning to take shape as a medical, rather than a strictly nursing, speciality.
Apgar accepted the advice and after her internship ended in 1936, she began a year-long anesthetist training course at the Presbyterian Hospital. After completing the course, Apgar performed residencies in anesthesiology at the University of Wisconsin and Bellevue Hospital in Manhattan, NYC. In 1938, she returned to the Presbyterian Hospital and became the director of the newly established division of anesthesia. Apgar was the first woman to hold the position of a director at the Presbyterian Hospital.
In 1949, Apgar also became the first female to hold a full professorship at P&S. Professorship in anesthesiology freed Apgar from many administrative duties, thus enabling her to devote more of her time to research.
Apgar noticed that infant (i.e., baby between the ages of 0 and 1) mortality in the United States rapidly declined between the 1930s and the 1950s. However, the death rate for babies in the first 24 hours after birth stayed the same. Perplexed by this discrepancy, Apgar began documenting the differences between healthy newborns and newborns requiring medical attention.
In 1952, Apgar created a test called the “Apgar score” that medical professionals could use to asses the health of newborn infants. The Apgar scoring system gives each newborn a score of 0, 1 or 2. Zero denotes the worst possible condition and two denotes the ideal condition across each of the following five categories: activity (muscle tone), pulse, grimace (reflex irritability), appearance (skin color) and respiration. To make her assessment easy to remember, the first letter of each of the five categories spells “APGAR.”
The use of the Apgar Score is credited with lowering the infant mortality rate by considerably increasing the likelihood of babies’ survival in the first 24 hours after birth.
The test is usually performed on newborn babies one minute and then five minutes after birth. A cumulative score of three or below is typically categorized as critically low and a cause for immediate medical action. Apgar’s test soon became common practice across the world. It remains a standard procedure to assess the health of newborn babies today.
In 1959, Apgar graduated with a Master of Public Health degree from Johns Hopkins University and began working for the March of Dimes Foundation—an American nonprofit organization that works to improve the health of mothers and babies—directing its research program with a focus on the treatment and prevention of birth defects.
While working at the March of Dimes, Apgar also became an outspoken advocate for universal vaccinations to prevent the mother-to-child transmission of rubella. Later in life, Apgar became a lecturer and then a clinical professor of pediatrics at Cornell University. She died on August 7, 1974.
Throughout her career, Apgar received numerous honorary doctorates and was awarded the Distinguished Service Award from the American Society of Anesthesiologists (1966) and the Woman of the Year in Science by Ladies Home Journal (1973). In 1995, she was inducted into the U.S. National Women’s Hall of Fame.
The use of the Apgar Score is credited with lowering the infant mortality rate by considerably increasing the likelihood of babies’ survival in the first 24 hours after birth. The invention and use of Apgar’s test has saved millions of lives and continues to save thousands more every day.