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.
References. 1  1. . Proposal for new method of evaluation of newborn infant. 2  2. . Apgar quartet plays perinatologist's instruments. 3  3. , , . The Apgar score as an index of neonatal mortality: a report from the Collaborative Study of Cerebral Palsy. 4  4. , . Apgar scores as predictors of chronic neurologic disability. 5  5. , , , .