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.
In addition, there has been vast improvement in ultrasound dating of the fetus in developed countries. The BMA is a simplified version of the Dubowitz scoring system for clinical determination of fetal maturation of newborn infants in the range of 26-44 weeks.
This was expanded in 1991 to the New Ballard Score (NBS) to include extremely preterm infants born at
The BMA is most reliable between 30 and 42 hours of life, whereas the NBS is most optimal at
At this time, the most accurate gestational age estimation is achieved by prenatal dating using the last menstrual period and early prenatal ultrasound, as well as postnatal physical examination and neurologic assessment.
A simplified score for assessment of fetal maturation of newly born infants.
J Pediatr. 1979; 95: 769-774
New Ballard Score, expanded to include extremely premature infants.
J Pediatr. 1991; 119: 417-423
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