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.
1 The Apgar score may not be as helpful to caregivers for newborns with very low birth weights, below 3.3 pounds (1500 grams). 2  Problems during pregnancy, such as an infection or injury from a fall, may cause a low Apgar score.