ABSTRACT
BACKGROUND AND OBJECTIVES: The New Ballard Score (NBS) is commonly used to estimate gestational age (GA) in the newborn. The aims of this study were: a) to determine the reliability of the NBS; b) to estimate the agreement between two methods of GA assessment, NBS and ultrasonography (US) or last menstrual period (LMP); c) to estimate the agreement between NBS and US/LMP in distinct subgroups of neonates. PATIENTS AND METHODS: We performed a prospective, blind study. NBS was performed in neonates born in Hospital 12 Octubre, Madrid before the age of 48 hours. The level of agreement was estimated with two analytical parameters: the intraclass correlation coefficient (ICC) and the mean differences method (MD). RESULTS: Inter-observer agreement was very good (ICC > 0.8). Agreement between US/LMP and NBS was good (ICC = 0.6-0.8). In infants with lower weight or GA, and in those whose mothers had received prenatal corticosteroid therapy, NBS tended to overestimate GA compared with US/LMP (MD = 1.2-2.9). CONCLUSIONS: The agreement between two observers in NBS assessment was very good. The agreement between NBS and US/LMP was good, but differences of more than 2 weeks in GA were frequent. In very preterm newborns and in infants whose mothers had received prenatal corticosteroid therapy, NBS tends to overestimate GA.
Subject(s)
Gestational Age , Infant, Low Birth Weight/growth & development , Infant, Premature/growth & development , Anthropometry , Humans , Infant, Newborn , Neurologic Examination , Physical Examination , Reproducibility of ResultsABSTRACT
Antecedentes y objetivos: El test de Ballard (NBS) es un método clínico utilizado frecuentemente para datar la edad gestacional (EG) del recién nacido. Los objetivos del estudio son: a) determinar la reproducibilidad del NBS; b) estimar el grado de acuerdo del NBS con la EG establecida por ecografía (ECO) y fecha de última regla (FUR), y c) determinar el grado de acuerdo del NBS con la EG estimada por ECO y FUR en distintos subgrupos de neonatos. Pacientes y métodos: Se trata de un estudio prospectivo y ciego, en el que se realiza el NBS a los neonatos con menos de 48 h de vida nacidos en el Hospital 12 de Octubre. La reproducibilidad y el grado de acuerdo se estimaron mediante el coeficiente de correlación intraclase (CCI) y el método de la media de las diferencias (MD). Resultados: El grado de acuerdo entre observadores estimado mediante el CCI fue muy bueno (> 0,8), y el obtenido entre ECO/FUR y NBS fue bueno (0,6-0,8). En los neonatos de menor peso y EG y en aquéllos cuyas madres habían recibido corticoides, se observó una tendencia a sobreestimar la EG mediante el NBS con respecto a la estimada por ECO/FUR (MD = 1,2-2,9). Conclusiones: Se halló un grado de acuerdo muy bueno entre los observadores. El grado de correlación del NBS con ECO/FUR es bueno, pero frecuentemente las diferencias en la asignación de la EG difieren en más de 2 semanas. En sujetos más inmaduros y en aquéllos cuyas madres recibieron corticoides existe tendencia a asignar mayor EG mediante NBS
Background and objectives: The New Ballard Score (NBS) is commonly used to estimate gestational age (GA) in the newborn. The aims of this study were: a) to determine the reliability of the NBS; b) to estimate the agreement between two methods of GA assessment, NBS and ultrasonography (US) or last menstrual period (LMP); c) to estimate the agreement between NBS and US/LMP in distinct subgroups of neonates. Patients and methods: We performed a prospective, blind study. NBS was performed in neonates born in Hospital 12 Octubre, Madrid before the age of 48 hours. The level of agreement was estimated with two analytical parameters: the intraclass correlation coefficient (ICC) and the mean differences method (MD). Results: Inter-observer agreement was very good (ICC > 0.8). Agreement between US/LMP and NBS was good (ICC = 0.6-0.8). In infants with lower weight or GA, and in those whose mothers had received prenatal corticosteroid therapy, NBS tended to overestimate GA compared with US/LMP (MD = 1.2-2.9). Conclusions: The agreement between two observers in NBS assessment was very good. The agreement between NBS and US/LMP was good, but differences of more than 2 weeks in GA were frequent. In very preterm newborns and in infants whose mothers had received prenatal corticosteroid therapy, NBS tends to overestimate GA
