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.
Background The 10-point Apgar score has been used to assess the condition and prognosis of newborn infants throughout the world for almost 50 years. Some investigators have proposed that measurement of pH in umbilical-artery blood is a more objective method of assessing newborn infants.