Pregnancy Clinical Trial
Official title:
Development of Standards for the New Ballard Maturation Score
The primary purpose of this study was to evaluate the accuracy of gestational age (GA) estimates by using the New Ballard Score (NBS) in newborns 24 to 27 weeks GA with accurate obstetric estimates of GA. Secondary purposes were: (1) to compare the accuracy of GA estimates derived from the NBS, the original Ballard score, and the physical items of the original Ballard score and (2) to compare these measures of GA and best obstetric estimates of GA as predictors of survival, morbidity, and hospital stay among infants <28 weeks' gestation and among very low birth weight infants in general.
The Ballard maturational assessment is commonly used to estimate gestational age (GA) when
the menstrual history and other obstetrical estimates of GA are uncertain. The original
Ballard Score and the New Ballard Score are based on the assumption that the fetal skin,
subcutaneous tissues, and neuromuscular system mature at predictable rates.
Because of variation in maturation rates among healthy fetuses or abnormalities of fetal
development, fetal maturation can vary at a given GA. For very premature infants, small
differences in GA result in large differences in outcome and may even determine whether
intensive care is given.
The primary purpose of this study was to evaluate the accuracy of GA estimates by using the
NBS in newborns 24 to 27 weeks GA with accurate obstetric estimates of GA. Secondary
purposes were: (1) to compare the accuracy of GA estimates derived from the NBS, the
original Ballard score, and the physical items of the original Ballard score and (2) to
compare these measures of GA and best obstetric estimates of GA as predictors of survival,
morbidity, and hospital stay among infants <28 weeks' gestation and among very low birth
weight infants in general.
For this study, eligible infants included those with birth weights of 401-1500g born in the
National Institute of Child and Human Development (NICHD) Neonatal Research Network (NRN).
Before 48 hours of age, enrolled infants were examined using the New Ballard Score by
trained and certified research nurses masked to obstetric estimates of gestational age. A
best obstetrical estimate of GA, used for screening of potentially eligible infants, was
determined from the last menstrual period, obstetrical measures, and ultrasound findings
recorded on the labor and delivery records.
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Observational Model: Cohort, Time Perspective: Prospective
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