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.
An Apgar score would give indication as to the health of the heart rate. The obstetrician is looking for a heart rate over 100 beats per minute. An Apgar score for a grimace is an indication of the degree of reflex to irritation. The Obstetrician may use a pinch of the skin and look for signs of a grimace as well as a sneeze, cough or cry.