| Simplification of Ballard'S Scoring System in Clinical Estimation of Gestational Age in Newborn Infants. |
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Woong Heum Kim, Jung Hwan Choi, Chong Ku Yun, Yong Ik Kim |
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Department of Pediatrics，and Department of Preventive Medicine，College of Medicine， Seoul National University |
| 신생아 재태기간 추정에 있어서 의 Ballard Scoring System 의 간이화
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김웅홈, 최중환, 김용익, 윤종구 |
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서울대학교 의과대학 소아과학교실 |
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| Abstract |
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Clinically, it is often required to identify that neonates are small, appropriate, or large-for-
gestational age, since the clinical course, outcome, and problems are quite different in each
group of infants. For this, accurate estimation of gestational age is required in addition to
birth weight.
Several methods to assess the gestational age based on the physical and neurological char-
acteristics of neonates have been developed and also there have been some trials to simplify
them in order to make it easier for both clinician and infant. Author tried to simplify the
Ballard’s maturity rating system by reducing the number of items while keeping its original
precision.
Three physicians assessed gestational age independently in 103 newborn infants who were
born at obstetric ward of Seoul National University Hospital from March to August in 1982.
The results were as follows:
1) The correlation coefficient between the gestation weeks estimated by Ballard* s method
and that calculated from LMP was 0.844, and regression equation for the latter (X) against
the former (Y) was Y=6.54+0.87X. 2) Individual items of Ballard’s system were compared for their predictiveness according to their correlation coefficients with gestational age by LMP and for interobserver agreement
according to kappa statistics. Then 6 items of posture, arm recoil, scarf sign, lanugo, plantar
crease and breast were selected by excluding 6 items which showed relatively low value in
correlation and/or agreement. 3) In order to simplify further while keeping reasonable precision,
combinations of 5 out of 6 items were compared for their predictiveness according to correlation coefficients between total scores of respective combinations and gestational age by LMP. In this comparison total
score of posture, arm recoil, scarf sign, plantar crease and breast showed best correlation
(R = 0.843). The total maturity score (simplified) was correlated with Y (gestational age by
LMP) as dependent variable of X (maturity score). The linear regression equation was Y =25.62+0.77X. 4) According to linear regression equation above, simplified maturity rating was developed as Table 5.
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| Key Words:
Gestational age, maturity rating, Ballard’s scoring system. |
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