mortality rate specifically within the first 24 hours of the infant's life. As an obstetric anesthesiologist, Apgar was able to document trends that could distinguish healthy infants from infants in trouble. This investigation led to a standardized scoring system used to assess a newborn's health after birth, with the result referred to as the newborn's "Apgar score". Each newborn is given a score of 0, 1 or 2 (a score of 2 meaning the newborn is in optimal condition, 0 being in distress) in each of the following categories: heart rate, respiration, color, muscle tone and reflex irritability. Compiled scores for each newborn can range between 0 and 10, with 10 being the best possible condition for a newborn. The scores were to be given to a newborn one minute after birth, and additional scores could be given in five-minute increments to guide treatment if the newborn's condition did not sufficiently improve. By the 1960s, many hospitals in the United States were using the Apgar score consistently. In the 21st century, the score continues to be used to provide an accepted and convenient method for reporting the status of the newborn infant immediately after birth . In 1959, Apgar left Columbia and earned a Master of Public Health degree from the Johns Hopkins School of Hygiene and Public Health. From 1959 until her death in 1974, Apgar worked for the March of Dimes Foundation, serving as vice president for medical affairs and directing its research program to prevent and treat birth defects. As gestational age is directly related to an infant's Apgar Score, Apgar was one of the first at the March of Dimes to bring attention to the problem of premature birth, now one of the March of Dimes' top priorities. During this time, she wrote and lectured extensively, writing articles in popular magazines as well as research work. In 1967, Apgar became vice president and director of basic research at The National Foundation-March of Dimes. During the rubella pandemic of 1964–65, Apgar became an advocate for universal vaccination to prevent mother-to-child transmission of rubella. Rubella can cause serious congenital disorders if a woman becomes infected while pregnant. Between 1964 and 1965, the United States had an estimated 12.5 million rubella cases, which led to 11,000 miscarriages or therapeutic abortions and 20,000 cases of congenital rubella syndrome. These led to 2,100 deaths in infancy, 12,000 cases of deafness, 3,580