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 scale is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria are summarized using words chosen to form a backronym (Appearance, Pulse, Grimace, Activity, Respiration).