Robert Wood Johnson University Hospital
 

Gestational Assessment

Newborn Babies - Gestational Assessment

What is a gestational assessment?

Assessing a baby's physical maturity is an important part of care. Maturity assessment is helpful in meeting a baby's needs if the dates of a pregnancy are uncertain. For example, a very small baby may actually be more mature than it appears by size, and may need different care than a premature baby.

An examination called the Dubowitz/Ballard Examination for Gestational Age is often used. A baby's gestational age often can be closely estimated using this examination. The Dubowitz/Ballard Examination evaluates a baby's appearance, skin texture, motor function, and reflexes. The physical maturity part of the examination is done in the first two hours of birth. The neuromuscular maturity examination is completed within 24 hours after delivery.

How is physical maturity assessed?

The physical assessment part of the Dubowitz/Ballard Examination examines physical characteristics that look different at various stages of a baby's gestational maturity. Babies who are physically mature usually have higher scores than premature babies.

Points are given for each area of assessment, with a low of minus one or minus two for extreme immaturity to as high as four or five for postmaturity. Areas of assessment include the following:

How is neuromuscular maturity assessed?

Six evaluations of the baby's neuromuscular system are performed. These include:

A score is assigned to each assessment area. Typically, the more neurologically mature the baby, the higher the score.

When the physical assessment score and the neuromuscular score are added together, the gestational age can be estimated. Scores range from very low for immature babies (less than 26 to 28 weeks) to very high scores for mature and postmature babies. However, the score may not be accurate in very low birth weight pretem infants (birth weight less than 1500gm).

All of these examinations are important ways to learn about your baby's well-being at birth. By identifying any problems, your baby's physician can plan the best possible care.

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