Article

New Ballard Score expanded to include premature infants

Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio, United States
Journal of Pediatrics (Impact Factor: 3.79). 10/1991; 119(3):417-23. DOI: 10.1016/S0022-3476(05)82056-6
Source: PubMed

ABSTRACT

The Ballard Maturational Score was refined and expanded to achieve greater accuracy and to include extremely premature neonates. To test validity, accuracy, interrater reliability, and optimal postnatal age at examination, the resulting New Ballard Score (NBS) was assessed for 578 newly born infants and the results were analyzed. Gestational ages ranged from 20 to 44 weeks and postnatal ages at examination ranged from birth to 96 hours. In 530 infants, gestational age by last menstrual period was confirmed by agreement within 2 weeks with gestational age by prenatal ultrasonography (C-GLMP). For these infants, correlation between gestational age by NBS and C-GLMP was 0.97. Mean differences between gestational age by NBS and C-GLMP were 0.32 +/- 1.58 weeks and 0.15 +/- 1.46 weeks among the extremely premature infants (less than 26 weeks) and among the total population, respectively. Correlations between the individual criteria and C-GLMP ranged from 0.72 to 0.82. Interrater reliability of NBS, as determined by correlation between raters who rated the same subgroup of infants, ws 0.95. For infants less than 26 weeks of gestational age, the greatest validity (97% within 2 weeks of C-GLMP) was seen when the examination was performed before 12 hours of postnatal age. For infants at least 26 weeks of gestational age, percentages of agreement with C-GLMP remained constant, averaging 92% for all postnatal age categories up to 96 hours. The NBS is a valid and accurate gestational assessment tool for extremely premature infants and remains valid for the entire newborn infant population.

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    • "For practical purposes, two neonatologists classified RDS with a grade of I to III, according to radiographic results (I – mild, slight reticulogranular appearance; II – moderate, reticulogranular appearance with air bronchograms; III – severe, unclear cardiac borders or white lung)[11]. Gestational age (completed weeks) was determined by menstrual age in women with regular menstrual cycles, by ultrasonography when a discrepancy of two or more weeks between menstrual age and ultrasonographic age occurred or in the absence of a menstrual date, or by the New Ballard Score in the absence of obstetrical indexes[12]. Intrauterine growth restriction was defined as a birth weight below the 3 rd centile of Fenton`s growth charts[13]. "

    Full-text · Article · Jan 2016
    • "Each mother brought her infant to the follow-up clinic when the infant was 4 months old (age corrected for prematurity for infants below 37 weeks gestation; Ballard et al., 1991). Infants were videotaped in the BAIT (Garcia Coll et al., 1988, 1992). "
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    • "GERD was based on need for antireflux medications as determined by the physician. Maturity level was measured as GA in weeks at birth, which was determined by physical examination using the New Ballard Score (Ballard et al., 1991). Milk type was assessed on the day when infants reached each milestone as either having some breast milk or having formula and used as a time-varying covariate in the analysis because of its potential to affect the feeding progression. "
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