Validade do exame clínico do recém-nascido para a estimação da idade gestacional: uma comparação do escore New Ballard com a data da última menstruação e ultra-sonografia

Moraes, Cláudia Leite; Reichenheim, Michael Eduardo

doi:10.1590/s0102-311x2000000100009

Cited by 19 publications

(13 citation statements)

References 40 publications

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“…Several suggest, as did the present one, that the Ballard score overestimated the gestational age in preterm infants leading to an underestimation of the percentages of preterm infants [32,33]. A study from Brazil reported poor sensitivity (70%) in detecting preterm infants when compared with ultrasonography [34]. In one study from Malawi, the external features of the Ballard were reliably obtained by nurses and led to an improvement in gestational age assessment when compared with dating by the last menstrual period or the fundal height [35].…”

Section: Discussionmentioning

confidence: 59%

Gestational age assessment in malaria pregnancy cohorts: a prospective ultrasound demonstration project in Malawi

Wylie

Kalilani-Phiri

Madanitsa

et al. 2013

Malar J

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BackgroundMalaria during pregnancy is associated with an increased risk for low birth weight (<2500 grams). Distinguishing infants that are born premature (< 37 weeks) from those that are growth-restricted (less than the 10th percentile at birth) requires accurate assessment of gestational age. Where ultrasound is accessible, sonographic confirmation of gestational age is more accurate than menstrual dating. The goal was to pilot the feasibility and utility of adding ultrasound to an observational pregnancy malaria cohort.MethodsIn July 2009, research staff (three mid-level clinical providers, one nurse) from The Blantyre Malaria Project underwent an intensive one-week ultrasound training to perform foetal biometry. Following an additional four months of practice and remote image review, subjects from an ongoing cohort were recruited for ultrasound to determine gestational age. Gestational age at delivery established by ultrasound was compared with postnatal gestational age assessment (Ballard examination).ResultsOne hundred and seventy-eight women were enrolled. The majority of images were of good quality (94.3%, 509/540) although a learning curve was apparent with 17.5% (24/135) images of unacceptable quality in the first 25% of scans. Ultrasound was used to date 13% of the pregnancies when menstrual dates were unknown and changed the estimated gestational age for an additional 25%. There was poor agreement between the gestational age at delivery as established by the ultrasound protocol compared to that determined by the Ballard examination (bias 0.8 weeks, limits of agreement -3.5 weeks to 5.1 weeks). The distribution of gestational ages by Ballard suggested a clustering of gestational age around the mean with 87% of the values falling between 39 and 41 weeks. The distribution of gestational age by ultrasound confirmed menstrual dates was more typical. Using ultrasound confirmed dates as the gold standard, 78.5% of preterm infants were misclassified as term and 26.8% of small-for gestational age infants misclassified as appropriately grown by Ballard.ConclusionUltrasound should be strongly considered in prospective malaria studies with obstetric endpoints to confirm gestational age and avoid misclassification of infants as premature or growth-restricted. The use of ultrasound does require a significant investment of time to maintain quality image acquisition.

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Section: Discussionmentioning

confidence: 59%

Gestational age assessment in malaria pregnancy cohorts: a prospective ultrasound demonstration project in Malawi

Wylie

Kalilani-Phiri

Madanitsa

et al. 2013

Malar J

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“…Ultrasound, as a tool to assess gestational age, is a limiting factor, particularly in developing countries, like India where only 51% of women undergo the recommended number of at least 3 antenatal visits; 59% of deliveries take place at home; and only 24% of pregnant women undergo ultrasonic evaluation during pregnancy (8). Assessment of gestational age of newborns using New Ballard Score (NBS) may not be reliable as its accuracy depends on the skill of examiner (9) and the condition of the neonate. It cannot be used in asphyxiated neonates.…”

Section: Introductionmentioning

confidence: 99%

Estimation of Gestational Age, Using Neonatal Anthropometry: A Cross-sectional Study in India

Thawani

Dewan

Faridi

et al. 2014

J Health Popul Nutr

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“…In the present study, despite the disagreement between the gestational age recorded in the hospital database and that of SINASC, all newborns were classified as premature (birth before 37 weeks of pregnancy), an expected fact when working with very low weight newborns. However, for epidemiological studies with SINASC data and that include newborns of all weight ranges, the inaccuracy of the gestational age recorded on the DN may be a potential source of difficulties in the identification of prematurity and of prematurity associated risk factors 7,29 .…”

Section: Discussionmentioning

confidence: 99%

Confiabilidade dos dados de uma população de muito baixo peso ao nascer no Sistema de Informações sobre Nascidos Vivos 2005-2006

Guimarães

Coeli

Cardoso

et al. 2012

Rev. bras. epidemiol.

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The objective of the present study was to evaluate the completeness and agreement between data obtained from the Live Birth Information System (SINASC) and hospital records for high neonatal risk situations. Using RecLink III software, a probabilistic data linkage was carried out using databases from a Public Health Neonatal Intensive Care Unit and SINASC (years 2005-2006), which made possible the analysis of data from 170 live births with very low birth weight (between 500g and 1,499g), present at both databases. Variables evaluated were: maternal age, number of antenatal care visits, delivery type, sex, birth weight, Apgar score at 1st and 5th minutes and gestational age. Completeness in SINASC varied from 91.8% (1st minute Apgar Score) to 100% (variables sex, delivery type and maternal age). To evaluate agreement, kappa coefficient was used for dichotomous variables, weighted kappa was used for ordinal variables and intraclass correlation coefficient (ICC) and Bland-Altman graphic approach were used for continuous variables. Agreement was considered good to excellent for 1ST minute Apgar score (weighted kappa = 0.98), delivery type (kappa = 0.96), maternal age (ICC = 0.95), 5TH minute Apgar Score (weighted kappa = 0.93), sex (kappa = 0.92) and antenatal care visits (weighted kappa = 0.76), but only fair for gestational age (weighted kappa = 0.50) and birth weight (ICC = 0.57). Although birth weight might be more prone to registry errors in high risk neonatal populations, the elevated reliability observed for most variables analyzed corroborates SINASC importance as a source of information for perinatal epidemiology studies, even when dealing with high risk neonatal situations.

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Validade do exame clínico do recém-nascido para a estimação da idade gestacional: uma comparação do escore New Ballard com a data da última menstruação e ultra-sonografia

Cited by 19 publications

References 40 publications

Gestational age assessment in malaria pregnancy cohorts: a prospective ultrasound demonstration project in Malawi

Gestational age assessment in malaria pregnancy cohorts: a prospective ultrasound demonstration project in Malawi

Estimation of Gestational Age, Using Neonatal Anthropometry: A Cross-sectional Study in India

Confiabilidade dos dados de uma população de muito baixo peso ao nascer no Sistema de Informações sobre Nascidos Vivos 2005-2006

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