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 score assessment is typically done at one and five minutes after birth and may be repeated later if the score remains low. If the score is low at ten, fifteen or thirty minutes after birth, there is a significant risk that the baby will suffer long-term brain damage.