Accuracy of New Ballard Score in Small-for-gestational Age Neonates.

OBJECTIVE: The aim of this study was to evaluate the performance of New Ballard Score (NBS) in small-for-gestational age (SGA) neonates.

METHODOLOGY: Neonates born at 35-40 weeks of gestation were included if accurate obstetric gestation estimate was available and birth weight was <10th percentile for gestation. Gestation-matched appropriate-for-gestational-age neonates were enrolled as controls. Gestation derived from NBS was compared with gestation calculated from last menstrual period.

RESULTS: Gestational age estimated by NBS was significantly higher in SGA neonates (mean difference: 0.7 weeks). Neuromuscular component score was similar but physical component score was significantly higher in SGA neonates. Reanalysis after reducing score of 4 to 3 of SGA babies for skin and plantar crease physical parameters showed overestimation of gestational age decreased to 0.4 weeks.

CONCLUSIONS: The physical parameters of NBS overestimate gestation in SGA neonates. Changing scores of skin and plantar creases in SGA neonates better estimates gestation age.