The accuracy of determining newborn’s maturity between New Ballard’s score, Ballard’s score, and first day of last menstrual period

  • Ferdy Limawal
  • Djauhariah A. Madjid
  • Dasril Daud
Keywords: New Ballard Score, Ballard Score, First day of last menstrual period

Abstract

Background Developing country such as Indonesia needs a tool
to assess gestational age which is simple, practical, cheap, fast,
and accurate. In 1991 the Ballard maturation score was refined
and expanded to achieve greater accuracy and called New Ballard
score.
Objective The purpose of this study was to determine the
correlation between gestational age assessed by New Ballard score,
Ballard score, and by the first day of last menstrual period (LMP).
Methods A cross sectional study has been carried out in Dr.
Wahidin Sudirohusodo, Ibnu Sina, Labuang Baji, and St. Fatimah
Hospitals in Makassar, from July 1 st , 2006 until January 31 st , 2007.
This study included healthy newborns, aged 15 minutes to 24
hours born to mothers who knew with certainty the first day of
their LMP. Diagnostic test was used to analyze the data.
Results There were 248 subjects included in this study. The results
showed that there was a strong correlation between gestational
age by LMP and New Ballard score (r=0.97), LMP and Ballard
score (r=0.95), as well as between New Ballard score and Ballard
score (r=0.99). New Ballard score was more accurate and had a
higher association coefficient (k=0.85) than did Ballard score
(k=0.82) to LMP in identifying premature baby. The sensitivity
of New Ballard score to identify premature baby was 87.7%,
specificity 96.3%, positive predictive value 95.2% and negative
predictive value 90.2 %.
Conclusions New Ballard score can be used to replace Ballard
score if LMP can not be assessed. Further study needs to be done
with bigger sample, involving other paramedics and unhealthy
newborn babies.

Author Biographies

Ferdy Limawal
Department of Child Health, Medical School, University of
Hasanuddin, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia.
Djauhariah A. Madjid
Department of Child Health, Medical School, University of
Hasanuddin, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia.
Dasril Daud
Department of Child Health, Medical School, University of
Hasanuddin, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia.

References

1. Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman
BL, Lipp R. New Ballard Score expanded to include extremely
premature infants. J Pediatr 1991;119:417-23.
2. Donovan EF, Tyson JE, Ehrenkranz RA, Verter J, Wright LL,
Korones SB. Inaccuracy of Ballard scores before 28 weeks’
gestation. National Institute of Child Health and Human
Development Neonatal Research Network. J Pediatr
1999;135:137-9.
3. Gabriel MMA. Assessment of the new Ballard score to
estimate gestational age. Ann Pediatr 2006;64:140-5.
4. Smith LN, Dayal VH, Monga M. Prior knowledge of obstetric
gestational age and possible bias of Ballard score. Obstet
Gynecol 1999;93:712-4.
5. Gomella TL. Assessment of weight and gestational age. In:
Gomella TL, Cunningham MD, Eyal FG, Zenk KE, editors.
Neonatology: management, procedures, on-call problems,
diseases, and drugs. 4 th ed. New York: McGraw-Hil Co; 1999.
p. 21-8.
6. Thilo EH, Rosenberg AA. The newborn infant. In: Hay WW,
Hayward AR, Levin MJ, Sondheimer JM, editors. Current
pediatric diagnosis and treatment. 16 th ed. New York:
McGraw-Hill Companies; 2003. p. 1-7.
7. Ballard JL, Novak KK, driver M. A simplified sore for
assessment of fetal maturation of newly born infants. J Pediatr
1979;95:769-74.
8. Yusran Y. Correlation of gestational age between LMP,
Dubowitz Score and Ballard Score [Thesis]. Makassar:
Department of Child Health, Hasanuddin University; 1995.
9. Alexander GR, de Caunes F, Hulsey TC, Tompkins ME, Allen
M. Validity of postnatal assessments of gestational age: a
comparison of the method of Ballard et al. and early
ultrasonography. Am J Obstet Gynecol 1992;166:891-5.
10. Moraes CL, Reichenheim ME. Validity of neonatal clinical
assessment for estimation of gestational age: comparison of
new Ballard score with date of last menstrual period and
ultrasonography. Cad Saude Publica 2000;16:83-94.
11. Stoll BJ, Kliegman RM. Overview of Mortality and morbidity.
In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson
textbook of pediatrics. 17 th ed. Philadelphia: WB Saunders
Co; 2004. p. 519-23.
Published
2008-05-01
How to Cite
1.
Limawal F, Madjid D, Daud D. The accuracy of determining newborn’s maturity between New Ballard’s score, Ballard’s score, and first day of last menstrual period. PI [Internet]. 1May2008 [cited 29Mar.2024];48(2):59-3. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/468
Section
Articles
Received 2016-09-05
Accepted 2016-09-05
Published 2008-05-01