Overview

Ballard Score, also known as the Ballard Maturational Assessment, is a method used to assess the gestational age of a newborn. It was developed by Dr. Jeanne Ballard in the 1970s. The assessment is based on physical and neuromuscular criteria, and it helps healthcare providers estimate the gestational age of a newborn when the exact gestational age is uncertain.

The Ballard Score involves the evaluation of both physical and neuromuscular characteristics, such as skin texture, lanugo (fine hair on the skin), plantar surface (underside) of the foot, breast development, ear form, and more. Each characteristic is assigned a score, and the cumulative score is then used to estimate the gestational age.

It's important to note that the Ballard Score is just one of several methods used to assess gestational age, and its accuracy can be influenced by various factors. Other methods, such as ultrasound, may also be used to determine gestational age, especially during pregnancy. The Ballard Score is typically employed when the newborn has already been delivered, and the gestational age needs to be estimated postnatally.

Prenatal Ultrasound

The prenatal ultrasound examination is one indirect method of assessing the gestational age of the fetus. Based upon fetal body part measurements, it relies upon normally timed and proportioned fetal growth rates. When performed early in gestation, fetal ultrasound is a highly accurate method of assessing gestational age. As the conceptus is exposed to a variety of intrauterine influences, fetal growth may be affected in a variety of ways. (ref 1) Fetal ultrasound measurements, affected by differential fetal growth, become increasingly subject to the intrauterine environment as a gestation progresses. Late trimester ultrasound measurements are therefore fraught with unavoidable inaccuracies as indicators of fetal gestational age. (ref 2,3)

Maturational Examination

The maturational examination, a postnatal, indirect method of assessing gestational age, is based upon indicators of fetal neuromuscular and physical maturation. (ref 4) As with fetal growth, fetal maturation may be influenced by a variety of intrauterine experiences. Stressful fetal experiences may accelerate pulmonary (ref 5) and neuromuscular (ref 6) rates of maturation while slowing or not affecting physical maturation. A completely non-stressed fetus may mature more slowly than the average fetus. The same events that accelerate fetal maturation may adversely affect fetal growth. Conversely, those that accelerate fetal growth may delay its maturation.