Review of Neonatal Assessment and Practice in Black, Asian and Minority Ethnic Newborns: Exploring the Apgar Score, the Detection of Cyanosis, and Jaundice

A new review published today by the NHS Race and Health Observatory outlines challenges in neonatal care for Black, Asian and minority ethnic babies, alongside clear recommendations on tackling them.

Tests and assessments that indicate the health of newborns, moments after birth, are limited and not fit-for-purpose for Black, Asian and ethnic minority babies, and need immediate revision according to the NHS Race and Health Observatory.

Neonatal assessments, including the Apgar score, a quick observation test used to assess babies minutes after birth was developed in 1952, and is now considered out of date by many healthcare professionals. Based on a score of 1 to 10, with a high Apgar score indicating good health for babies, minutes following birth, the assessments are used as standard by healthcare professionals regardless of a baby’s skin tone and can give misleading scores.

The review also highlights particular concerns around perinatal practices including the assessment of cyanosis and jaundice – the development of which has also been based upon White European babies, and normalised regardless of their applicability to diverse populations and neonates with varying skin tones.

The review presents recommendations for policy, practice and research.