Apgar scoring can be affected by maternal administration of which medication?

• A. Magnesium sulfate
• B. Epidural anesthesia
• C. Antibiotics
• D. Insulin

Answer: (A)

Apgar scoring reflects how well a newborn has adapted to life outside the womb, using five quick checks: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Medications given to the mother that cross the placenta and depress the newborn’s nervous system or breathing can lower the score. Magnesium sulfate crosses the placenta and acts as a CNS depressant, which can blunt neonatal reflexes, reduce muscle tone, and slow respirations, leading to a lower Apgar score, especially at the 1-minute mark. Epidural anesthesia is usually well tolerated and may cause transient effects only if significant maternal hypotension or opioid exposure is present, but it’s less consistently associated with lower Apgar scores. Antibiotics and insulin don’t have a direct, reliable impact on the immediate newborn performance measured by Apgar.