MATURATIONAL ASSESSMENT OF GESTATIONAL AGE (New Ballard Score)

NAME________________________________ SEX __________________________________

HOSPITAL NO. ________________________ BIRTH WEIGHT ________________________
RACE_________________________________ LENGTH ______________________________
DATE/TIME OF BIRTH __________________ HEAD CIRC. ___________________________
DATE/TIME OF EXAM __________________ EXAMINER ___________________________
AGE WHEN EXAMINED ________________
APGAR SCORE: 1 MINUTE _____________5 MINUTES ______________10 MINUTES______________

NEOMUSCULAR MATURITY
SCORE
SCORE RECORD
NEUROMUSCULAR Neuromuscular _______
MATURITY SIGN
SCORE
-1 0 1 2 3 4 5 HERE Physical ______________
Total ________________

POSTURE
MATURITY RATING

SQUARE WINDOW SCORE WEEKS

(Wrist)
>90° 90° 60° 45° 30° 0° -10 20

ARM RECOIL -5 22
180° 140 –180° 110 –140° 90 –110° <90°
0 24

POPLITEAL ANGLE 5 26
180° 160° 140° 120° 100° 90° <90°
10 28
SCARF SIGN 15 30

20 32
HEEL TO EAR
25 34

30 36
TOTAL NEUROMUSCULAR
MATURITY SCORE
35 38
PHYSICAL MATURITY 40 40
SCORE RECORD
PHYSICAL 45 42
MATURITY SIGN
SCORE
-1 0 1 2 3 4 5 HERE
50 44
sticky gelatinous superficial cracking parchment leathery
smooth pink
SKIN friable red peeling &/or pale areas deep cracking cracked
visible veins
transparent translucent rash, few veins rare veins no vessels wrinkled
GESTATIONAL AGE
(weeks)
LANUGO none sparse abundant thinning bald areas mostly bald By dates _____________
By ultrasound ________
heel-toe anterior By exam _____________
>50 mm faint creases creases over
PLANTAR SURFACE 40–50 mm: -1 transverse
no crease red marks ant. 2/3 entire sole
< 40 mm: -2 crease only

barely flat areola stippled areola raised areola full areola

BREAST imperceptible
perceptible no bud 1–2 mm bud 3–4 mm bud 5–10 mm bud

lids fused lids open sl. curved well-curved

formed & firm thick cartilage
EYE / EAR loosely: -1 pinna flat pinna; soft; pinna; soft but
instant recoil ear stiff
tightly: -2 stays folded slow recoil ready recoil

testes in testes testes

GENITALS scrotum flat, scrotum empty upper canal testes down
(Male)
descending pendulous
smooth faint rugae good rugae
rare rugae few rugae deep rugae
clitoris prominent prominent majora & majora
GENITALS clitoris & majora large
prominent clitoris & small minora equally cover clitoris
(Female) enlarging minora small
& labia flat labia minora minora prominent & minora

Reference TOTAL PHYSICAL

Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature infants.
J Pediatr 1991; 119:417–423. Reprinted by permission of Dr Ballard and Mosby—Year Book, Inc.
MATURITY SCORE
 CLASSIFICATION OF NEWBORNS (BOTH SEXES)
BY INTRAUTERINE GROWTH AND GESTATIONAL AGE1,2
NAME ____________________________________________ DATE OF BIRTH ___________________________________ LENGTH _________________________________________

HOSPITAL NO. _____________________________________ SEX _____________________________________________ HEAD CIRC. ______________________________________

RACE ____________________________________________ BIRTH WEIGHT ____________________________________ GESTATIONAL AGE

DATE OF BIRTH ___________________________________

WEIGHT PERCENTILES LENGTH PERCENTILES

4600 54
90
4400 53
4200 52
75
4000 90 51
3800 50 50
75
3600 49
25
3400 50
48
3200 47
25 10
3000 46
2800 10 45

Length (cm)
Weight (g)

2600 44
2400 43
2200 42
2000 41
1800 40
1600 39
1400 38
1200 37
1000 36
800 35
600 34
PRETERM TERM
400 33
0 32
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 PRETERM TERM
Gestational Age (week) 31
0
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Gestational Age (week)
HEAD CIRCUMFERENCE PERCENTILES
38
37
90 CLASSIFICATION OF INFANT* Weight Length Head Circ.
36
75
35 50 Large for
34 Gestational Age (LGA)
25
33
Head Circumference (cm)

10 (>90th percentile)
32
31 Appropriate for
30
Gestational Age (AGA)
29
(10th to 90th percentile)
28
27
Small for
26
Gestational Age (SGA)
25
(<10th percentile)
24
23
PRETERM TERM *Place an "X" in the appropriate box (LGA), AGA or SGA) for weight, for
22 length and for head circumference.
0
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
Gestational Age (week)

References
1. Battaglia FC, Lubchenco LO: A practical classification of newborn infants by weight and gestational age.
J Pediatr 1967; 71:159-163.
2. Lubchenco LO, Hansman C, Boyd E: Intrauterine growth in length and head circumference as estimated
from live births at gestational ages from 26 to 42 weeks. Pediatrics 1966; 37:403-408.
Reprinted by permission from Dr Battaglia, Dr Lubchenco, Journal of Pediatricsand Pediatrics

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