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.
The Apgar score is assigned in the first few minutes after birth to help identify babies that have difficulty breathing or have a problem that needs further care. The baby is checked at 1 minute and 5 minutes after birth for heart and respiratory rates, muscle tone, reflexes, and color.