Early identification of preterm neonates at birth with a Tablet App for the Simplified Gestational Age Score (T-SGAS) when ultrasound gestational age dating is unavailable: A validation study

Abstract

Background In low resource settings recall of the date of the mother's last menstrual period may be unreliable and due to limited availability of prenatal ultrasound, gestational age of newborns may not be assessed reliably. Preterm babies are at high risk of morbidity and mortality so an alternative strategy is to identify them soon after birth is needed for early referral and management. Objective The objective of this study was to assess the accuracy in assessing prematurity of newborn, over and above birthweight, using a pictorial Simplified Gestational Age Score adapted for use as a Tablet App. Methods Two trained nurse midwives, blinded to each other's assessment and the actual gestational age of the baby used the app to assess gestational age at birth in 3 hospitals based on the following 4 parameters-newborn's posture, skin texture, breast and genital development. Inter-observer variation was evaluated and the optimal scoring cutoff to detect preterm birth was determined. Sensitivity and specificity of gestational age score using the tablet was estimated using combinations of last menstrual period and ultrasound as reference standards to assess preterm birth. The predictive accuracy of the score using the area under a receiver operating characteristic curve was also determined. To account for potential reference standard bias, we also evaluated the score using latent class models.

Assessment of Different Technique of Eliciting the Planter Reflex in Term Neonates

“…A number of studies on neonatal health and their neurodevelopmental aspects were reported [14][15][16][17]. Few of the related studies were reviewed [18][19][20].…”

Estimating the Association of Ultrasonographical Placental Grading in Utero to Gestational Age and Feto-maternal outcomes in Hypertensive Disorders of Pregnancy

“…The problems of eclampsia is evident from many GBD studies [14][15][16]. Few studies related to pregnancy and ultrasonography were reviewed [17][18][19][20]. Studies done in Institute of medical lab technology showed that grade 2 placenta were associated with hypertensive pregnancies and more incidences of lower abdominal pain.…”

New Technologies to Dating Pregnancy at Birth

“…The NBS, DWS, and MS were reduced to four, five, and six items, respectively, and all of them reduced total scores were not significantly different from the total score's estimate of gestational (p > 0.05). Such promising results and ease-to-use approach conducted to an adaptation to a mobile application, the T-SGAS, include a simple score associated with simple technology, using an app with combinations of references standards [34].…”

“…ROC curves showed that the predictive accuracy of T-SGAS varied between 74% (LMP or USG) to 79% (LMP and USG). The simplicity of use by nurse-midwives has pointed it to be a helpful tool in resource-limited settings [34].…”