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A SIMPLIFIED ASSESSMENT OF GESTATIONAL AGE

Accurate gestational assessment is important for the appropriate management of every newborn infant. There is still a need for a simple yet reliable method which could be used by ancillary personnel as well as physicians. A score was developed by condensing the methods of Dubowitz and others. The new score consists of 6 neurologic and 6 physical criteria (see Klaus and Fanaroff: CARE OF THE HIGH RISK NEONATE p. 47, W.B.Saunders,1973). To obtain this, multiple physical criteria were combined into single observations and neurologic signs using active muscle tone (which are misleading in sick infants) were eliminated. To test the accuracy of the simplified system, the Dubowitz method was used as a standard, and 284 babies were examined by both methods by unbiased observers. Ages ranged from 12 to 96 hrs with weights ranging from 760 to 5460 gms. Correlation between the two examinations was 0.975, p<.001). Individual criteria of the simplified score on a second group of 86 infants were then weighted for predictive value according to their correlation with known dates. The gestational age tended to be more closely related to the individual components of the physical assessment (r=0.614-0.784) than to the neurologic criteria (r-0.437-0.756). The correlation for the score obtained for the total assessment (r=0.952) was greater than that for any of the individual components. The average time required for Dubowitz exam was 10-15 min, the simplified method 3-4 min. This simplified scoring system provides a rapid and accurate assessment of gestational age.