Comparison of Expanded New Ballard, Eregie and Parkin Scores in Predicting Gestational Age in Newborns

Abstract

Background: Postnatal gestational age (GA) estimation is crucial in neonates with absent early trimester ultrasonography (USG) reports to evaluate the risk of morbidity and mortality. Widely used Expanded New Ballard (ENBS) is complex and needs expert medical professional to assess. Eregie (ES) and Parkin (PS) scores are easy to perform with good inter-observer reliability. We aimed to compare these scores for their ability in predicting GA with early trimester USG-GA as gold standard. Methods: This cross-sectional study was conducted among 1114 intramural neonates who qualified the selection criteria. All neonates were evaluated using three scores by residents (blinded to USG-GA) with an acceptable inter-observer difference of <10%. Method applicability was compared in terms of agreement, correlation, accuracy and validity. Results: Gestational age was systematically overestimated by 0.65 weeks, 0.68 weeks, and 0.32 weeks by ENBS, PS and ES respectively. Correlation coefficient was highest for ENBS (ρ value 0.724). For GA sub-groups, ES had best overall accuracy with MD of 0.32 ± 0.88 weeks. Validity was highest for ES (79.6%). Interpretation: We conclude that all three scores were found to be in acceptable agreement, good accuracy and validity. ES had best overall accuracy and validity among the subjects and for subgroups. Hence we recommend that in limited resource settings, ES or PS can substitute for ENBS. Funding: None. Declaration of Interests: None. Ethics Approval Statement: Ethical clearance was obtained from Institutional Human ethics Committee, Mahatma Gandhi Medical College and Research Institute (MGMCRI), Pondicherry, India. All the parents of the participants provided written informed consent before participation.