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Silverman-Andersen score

A score that sums five visible signs of respiratory effort in a newborn, each graded 0 to 2, giving a total from 0 to 10.

Also called: Silverman–Andersen score, Silverman Andersen score

Total0

—Choose one option in each group

Upper chest movementchoose one
Lower chest retractionchoose one
Xiphoid retractionchoose one
Nasal flaringchoose one
Expiratory gruntchoose one

Bands

0
No distressBreathing is comfortable, with no visible increase in work of breathing.
1 to 3
MildMild increase in the visible work of breathing.
4 to 6
ModerateModerate increase in the visible work of breathing.
7 to 10
SevereMarked increase in the visible work of breathing.

Educational use only. Guideline: Silverman and Andersen 1956; bands after Kumar 2025. Source: Hedstrom AB, Gove NE, Mayock DE, Batra M. Performance of the Silverman Andersen Respiratory Severity Score in predicting PCO2 and respiratory support in newborns. Journal of Perinatology. 2018. https://doi.org/10.1038/s41372-018-0049-3; Kumar I, Kukreja K, Kumar A, et al. Predicting neonatal RDS with fetal pulmonary artery Doppler: a diagnostic performance and ROC curve analysis. The Ultrasound Journal. 2025. https://doi.org/10.1186/s13089-025-00456-y.

Card id: silverman-andersen-score

Sources

  • Hedstrom AB, Gove NE, Mayock DE, Batra M. Performance of the Silverman Andersen Respiratory Severity Score in predicting PCO2 and respiratory support in newborns. Journal of Perinatology. 2018. https://doi.org/10.1038/s41372-018-0049-3
  • Kumar I, Kukreja K, Kumar A, et al. Predicting neonatal RDS with fetal pulmonary artery Doppler: a diagnostic performance and ROC curve analysis. The Ultrasound Journal. 2025. https://doi.org/10.1186/s13089-025-00456-y

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