A Simple Method of Assessment of Gestational Age in Newborn Infants

Narayanan, Indira; Dua, Kavita; Gujral, V. V.; Dk, Mehta; Mathew, M; Prabhakar, A. K.

doi:10.1542/peds.69.1.27

Pediatrics

1982

DOI: 10.1542/peds.69.1.27

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A Simple Method of Assessment of Gestational Age in Newborn Infants

Indira Narayanan

Kavita Dua

V. V. Gujral

et al.

Abstract: A simple method of assessment of gestational age based on only four characteristics, namely, the anterior vascular capsule of the lens, plantar creases, breast nodule, and ear firmness, is presented. Critical evaluation by appropriate statistical analyses has shown this to be a useful method of practical value with 95% confidence limits of 11 days. It is applicable to newborn infants, including sick babies, at any time within the first 2 days of life.

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Cited by 26 publications

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“…Simplified methods have been developed in India [9][10][11][12], but they have not been adapted for use by community health workers to assess LBW babies. Therefore, our objectives were (1) to develop a simplified GA score (SGAS) by selecting items from 3 standard GA scores that significantly predict the GA as measured by the best obstetric estimate (BOE), (2) to validate the accuracy of SGAS against the BOE, (3) to compare the accuracy of SGAS to assess the GA as compared to the accuracy of GA assessment by the New Ballard Score (NBS), and (4) to assess inter rater agreement of SGAS as compared to that of NBS.…”

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confidence: 99%

Development and initial validation of a simplified gestational age score in low birth weight newborns in India

Patel¹,

Lothe²,

Belekar³

et al. 2014

Indian J Child Health

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Background: Assessment of gestational age (GA) based on the last date of menstrual period is often inaccurate. Scores to predict GA of newborns are difficult to use particularly by health workers. An accurate, easy to use the method of assessing GA, particularly in low birth weight (LBW) babies, is needed to detect and link premature newborns to the appropriate level of care. Objectives: The objectives were (1) to develop a "simplified GA score" (SGAS) by selecting items from 3 standard GA scores that significantly predict the GA as measured by the best obstetric estimate (BOE), (2) to validate the accuracy of SGAS against the BOE, (3) to compare the accuracy of SGAS to assess the GA as compared to the accuracy of GA assessment by the New Ballard Score (NBS), and (4) to assess inter rater agreement of SGAS as compared to that of NBS. Materials and Methods: Both the development and validation studies were cross-sectional studies. In the development study, two neonatology residents trained in the use of the 3 scores assessed LBW (<2,500 g) newborns within 24 h of birth. The residents were blinded to each other's assessment and the BOE (GA obtained from last menstrual period [LMP] and confirmed by ultrasound (USG) to be within 2 weeks of the GA ascertained by LMP). Items significantly predictive of GA in multiple regressions were included in the SGAS. In the validation study, two different neonatology residents trained in the use of SGAS assessed the same LBW newborns within 24 h of birth, blinded to each other's assessment and the BOE. Results: In 171 LBW newborns enrolled in the development study, 4 items (Skin, breast, genitals, and posture) were selected for the SGAS. The prevalence of very preterm (<32 weeks) was similar to the actual prevalence. Agreement between the two ratters for SGAS (Cohen's kappa 0.825) was better than that for the NBS (Cohen's kappa 0.709). SGAS had higher positive predictive value for <32 weeks and for ≥32 weeks to ≤35 weeks as compared to the NBS. Conclusions: SGAS is a promising scale for assessment of GA. It needs further validation by public health nurses and community health workers of low resource settings.

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mentioning

confidence: 99%

Development and initial validation of a simplified gestational age score in low birth weight newborns in India

Patel¹,

Lothe²,

Belekar³

et al. 2014

Indian J Child Health

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Assessment of gestational age and neuromaturation

Allen¹

2005

Ment. Retard. Dev. Disabil. Res. Rev.

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Neuromaturation is the functional development of the central nervous system (CNS). It is by its very nature a dynamic process, a continuous interaction between the genome and first the intrauterine environment, then the extrauterine environment. Understanding neuromaturation and being able to measure it is fundamental to infant neurodevelopmental assessment. Fetal and preterm neuromaturation has become easier to observe with the advent of prenatal ultrasonography and neonatal intensive care units. A number of measures of degree of fetal maturation have been developed and used to estimate gestational age (GA) at birth. The most reliable measures of GA are prenatal measures, especially from the first trimester. Postnatal GA measurements tend to be least accurate at the extremes of gestation, that is, in extremely preterm and post-term infants. Observations of measures of neuromaturation in infants born to mothers with pregnancy complications, including intrauterine growth restriction, multiple gestation, and chronic hypertension, have led to the discovery that stressed pregnancies may accelerate fetal pulmonary and CNS maturation. This acceleration of neuromaturation does not occur before 30 weeks' gestation and has a cost with respect to cognitive limitations manifested in childhood. The ability to measure fetal and preterm neuromaturation provides an assessment of neurodevelopmental progress that can be used to reassure parents or identify at risk infants who would benefit from limited comprehensive follow-up and early intervention services. In addition, measures of neuromaturation have the potential to provide insight into mechanisms of CNS injury and recovery, much-needed early feedback in intervention or treatment trials and a measure of early CNS function for research into the relationships between CNS structure and function.

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Determination of gestational age: Comparative accuracy of different methods

1989

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One hundred new-born infants were studied in an attempt to test the accuracy of selected methods of post-natal assessment of gestational age. The Finnstrom method using seven external characteristics was found to be relatively more accurate both in preterm and term infants. Dubowitz and Cappuro method were accurate in premature infants only. However in a limited number of post-term infants Cappuro method yielded better results. The Finnstrom method can be recommended for routine assessment of gestational age.

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A Simple Method of Assessment of Gestational Age in Newborn Infants

Cited by 26 publications

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Development and initial validation of a simplified gestational age score in low birth weight newborns in India

Development and initial validation of a simplified gestational age score in low birth weight newborns in India

Assessment of gestational age and neuromaturation

Determination of gestational age: Comparative accuracy of different methods

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