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Updated: Aug 4, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Assessment of the new Ballard score to estimate gestational age]
M A Marín Gabriel1, J Martín Moreiras, G Lliteras Fleixas
1Departamento de Pediatría, Hospital 12 de Octubre, Madrid, Spain. pedmgma@terra.es
Background And Objectives:
The New Ballard Score (NBS) is commonly used to estimate gestational age (GA) in the newborn. The aims of this study were: a) to determine the reliability of the NBS; b) to estimate the agreement between two methods of GA assessment, NBS and ultrasonography (US) or last menstrual period (LMP); c) to estimate the agreement between NBS and US/LMP in distinct subgroups of neonates.
Patients And Methods:
We performed a prospective, blind study. NBS was performed in neonates born in Hospital 12 Octubre, Madrid before the age of 48 hours. The level of agreement was estimated with two analytical parameters: the intraclass correlation coefficient (ICC) and the mean differences method (MD).
Results:
Inter-observer agreement was very good (ICC > 0.8). Agreement between US/LMP and NBS was good (ICC = 0.6-0.8). In infants with lower weight or GA, and in those whose mothers had received prenatal corticosteroid therapy, NBS tended to overestimate GA compared with US/LMP (MD = 1.2-2.9).
Conclusions:
The agreement between two observers in NBS assessment was very good. The agreement between NBS and US/LMP was good, but differences of more than 2 weeks in GA were frequent. In very preterm newborns and in infants whose mothers had received prenatal corticosteroid therapy, NBS tends to overestimate GA.
