50 Years Ago in The Journal of Pediatrics


Dubowitz LM, Dubowitz V, Goldberg C. Clinical assessment of gestational age in the newborn infant. J Pediatr 1970;77:1-10.

In 1970, L. M. Dubowitz, V. Dubowitz, and C. Goldberg studied neurologic and external characteristics previously described in the clinical assessment of gestational age. They found a wide overlap in the gestational age at which an individual neurologic sign might be present or absent, resulting in difficulty predicting gestation objectively. A combination of neurologic signs and external characteristics identified in newborn infants for the clinical assessment of gestational age was described. Neurologic assessments were selected based on being easily definable and reproducible by multiple observers. These assessments were also the ones least influenced by the state of the newborn. A scoring system for all criteria, including both neurologic and external characteristics, was then developed. This Dubowitz scoring system resulted in a more objective and reliable method of assessing gestational age than that based on the presence or absence of individual criteria as described previously.

This high-impact study paved the way for a comprehensive and cohesive examination of newborns throughout pediatric medicine. Over the past 50 years, there have been further developments in newborn gestational age assessment tools, most notably the Ballard Maturational Assessment (BMA) described by Ballard et al in 1979.

  • Ballard J.L.
  • Novak K.K.
  • Driver M.
A simplified score for assessment of fetal maturation of newly born infants.