nbs scoring.pdf
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WEEK OF GESTATION
CM.
53
52
51
5049
48
47
46
45
44
43
42
41
40
39
38
3736
35
34
33
32
31
30
0
GM.
2400
2200
2000
1800
1600
1400
1200
1000
800
600
400
0
GM.
4000
3800
3600
3400
3200
3000
2800
2600
90%
75%
50%
25%
10%
WEIGHT______ gm
LENGTH______ cm
PRE-TERM TERM POST-TERM
90%
75%
50%
25%
10%
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43
WEEK OF GESTATION
CM.
42
41
40
3938
37
36
35
34
33
32
31
30
29
28
27
2625
24
23
22
0
3.60
3.50
3.40
3.30
3.20
3.10
3.00
2.90
2.80
2.70
2.60
2.50
2.40
2.30
2.20
2.10
2.00
1.90
1.80
1.70
1.60
0
INTRAUTERINE WEIGHT-LENGTH RATIO
100 w GRAMS/L3 CENTIM ETERS
BOTH SEXES
HEAD CIRCUM-
FERENCE______ cm
9
7
5
2
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42
WEEK OF GESTATION
7
5
2
1
9
CLASSIFICATION OF NEWBORNS -BASED ON MATURITY AND INTRAUTERINE GROWTH
Symbols: X - 1st Exam O - 2nd Exam
1st Exam (X) 2nd Exam (O)
LARGE FOR GESTATIONAL AGE (LGA)
APPROPRIATE FOR GESTATIONAL AGE (AGA)
SMALL FOR GESTATIONAL AGE (SGA)
Age at Exam hrs hrs
Signature of Examiner M.D./R.N. M.D./R.N.
LB146 REV 6/04 ©1988, 1992, 1997, 1999 Mead Johnson & Company, Evansville, Indiana 47721 U.S.A.
Adapted from Lubchenco LO, Hansman C, and Boyd E: Pediatr.
1966;37:403; Battaglia FC, and Lubchenco LO:J Pediatr.
1967;71:159.
Sid
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NEWBORN MATURITY RATING & CLASSIFICATION
ESTIMATION OF GESTATIONAL AGE BY MATURITY RATINGSymbols: X - 1st Exam O - 2nd Exam
Side
Gestation by Dates ______________________wks
am
Birth Date ______________Hour __________ pm
APGAR________________1 min _________5 min
MATURITY RATING
score weeks
-10 20
-5 22
0 24
5 26
10 2815 30
20 32
25 34
30 36
35 38
40 40
45 42
50 44
SCORING SECTION
1st Exam=X 2nd Exam=O
EstimatingGest Age
by MaturityRating ________Weeks _________Weeks
Time of Date__________ Date __________ Exam am am
Hour _______pm Hour________pm
Age at
Exam _________Hours _________Hours
Signature ______________ ______________ of
Examiner ______________ ______________ M.D./R.N. M.D./R.N.
PHYSICAL MATURITY
superficial parchment;sticky; gelatinous; smooth; peeling cracking; deep leathery;
Skin friable; red; pink; &/or rash; pale areas; cracking; cracked;transparent translucent visible veins few veins rare veins no vessels wrinkled
bald mostlyLanugo none sparse abundant thinning areas bald
heel-toe >50 mm; faint anterior creasesPlantar 40-50 mm: -1 no red transverse creases overSurface <40 mm: -2 crease marks crease only ant. 2/3 entire sole
stippled raised ful l areola;Breast imperceptib le bare ly flat areola; areo la ; areola; 5 -10 mm
percept ible no bud 1-2 mm bud 3-4 mm bud bud
well-curved formedlids fused lids open; sl. curved pinna; & firm; thick
Eye/Ear loosely: -1 pinna flat ; pinna; sof t; soft but instant carti lage;tightly: -2 stays folded slow recoil ready recoil recoil ear stiff
scrotum scrotum testes in testes testes testesGenitals flat; empty; upper canal; descending; down; pendulous;
male smooth faint rugae rare rugae few rugae good rugae deep rugae
prominent prominent majora majora majora
Genitals clitoris clitoris; clitoris; & minora large; coverfemale prominent; small enlarging equally minora clitoris
labia flat labia minora minora prominent small & minora
Scoring system: Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL,Lipp R. New Ballard Score, expanded to include extremely premature infants.J Pediatr . 1991;119:417-423.
NEUROMUSCULAR MATURITY
-1 0 1 2 3 4 5
Posture
SquareWindow(wrist) >90° 90° 60° 45° 30° 0°
Arm Recoil
180° 140°-180° 110°-140° 90°-110° <90°
PoplitealAngle
180° 160° 140° 120° 100° 90° <90°
Scarf Sign
Heel to Ear
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LB146 REV 11/99
Unified System for Gestational AgeEvaluation and
Classification of the Newborn
Accurate estimation of gestational age and the evaluation of the appropriateness of
fetal growth are vital in the care of newborns. A unified system has been developed
which enables the physician and other health care professionals to rapidly yet
accurately classify all newborns and identify the high-risk neonate.
The form consists of two complementary evaluations—(1) gestational age in weeks
based upon selected neurologic and physical characteristics; and (2) fetal growth
(weight, length, and head circumference) compared to normal standards. By these
evaluations, neonates can be categorized as appropriate-for-gestational age (AGA),
small-for-gestational age (SGA), and large-for-gestational age (LGA). In addition, they
can also be identified as pre-term (less than 37 weeks' gestation, term (37 to 42
weeks' gestation) or post-term (greater than 42 weeks' gestation).
To ensure accuracy, the procedure should be followed as outlined. This record should
be placed with the newborn's permanent record.
Developed by Jacob L. Kay, M.D., Seton Medical Center, Austin, Texas;in conjunction with Mead Johnson Nutritionals, Evansville, Indiana.
©1988, 1992, 1997 Mead Johnson & Company, Evansville, IN 47721 U.S.A.
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