It's Hawaii and Alaska. AdiÂ­tionÂ­alÂ­ly, Hawaii is the only state not located in the AmerÂ­iÂ­cÂ­as.
However, the purpose of the Apgar test is to determine quickly whether a newborn needs immediate medical care; it was not designed to make long-term predictions on a child's health. A score of 10 is uncommon due to the prevalence of transient cyanosis, and is not substantially different from a score of 9.
Apgar V. A proposal of a New Method of Evaluation of the Newborn Infant. Current Researches in Anesthesia and Analgesia. 1953, 32: 261-267. Apgar V, Holaday DA, James LS, et. al. Evaluation of the newborn infant. JAMA. 1958, 168: 1985-1988. Casey BM, McIntire DD, Leveno KJ. The continuing value of the Apgar score for the assessment of newborn infants.