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Related Experiment Videos

New Ballard Score, expanded to include extremely premature infants.

J L Ballard1, J C Khoury, K Wedig

  • 1Department of Pediatrics, University of Cincinnati College of Medicine, OH 45267-0541.

The Journal of Pediatrics
|September 1, 1991
PubMed
Summary

The New Ballard Score (NBS) accurately assesses gestational age in newborns, including extremely premature infants. This refined tool demonstrates high validity and reliability for clinical use.

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Area of Science:

  • Neonatalogy
  • Pediatrics
  • Maternal-Fetal Medicine

Background:

  • The Ballard Maturational Score is a clinical tool for assessing gestational age.
  • Existing scores may lack accuracy for extremely premature neonates.

Purpose of the Study:

  • To refine and expand the Ballard Maturational Score into the New Ballard Score (NBS).
  • To assess the validity, accuracy, interrater reliability, and optimal examination timing of the NBS.
  • To evaluate the NBS's performance in extremely premature infants and the general newborn population.

Main Methods:

  • The New Ballard Score (NBS) was assessed in 578 newborns with gestational ages from 20 to 44 weeks.
  • Gestational age by NBS was compared to gestational age derived from last menstrual period (LMP) and confirmed by prenatal ultrasonography (C-GLMP).

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  • Interrater reliability was assessed by comparing ratings from different examiners.

    • Main Results:

    • The NBS demonstrated high correlation (0.97) with C-GLMP for infants with confirmed gestational ages.
    • Mean differences between NBS and C-GLMP were minimal (0.32 ± 1.58 weeks for <26 weeks, 0.15 ± 1.46 weeks for all infants).
    • High interrater reliability (0.95) was observed. Optimal validity for extremely premature infants (<26 weeks) was achieved within 12 hours of birth.

    Conclusions:

    • The New Ballard Score (NBS) is a valid and accurate tool for gestational age assessment in extremely premature infants.
    • The NBS maintains its validity across the entire newborn population up to 96 hours postnatal age.
    • The NBS is a reliable instrument for clinical evaluation of gestational maturity.