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Postnatal Overestimation of Gestational Age in Preterm Infants

Postnatal Overestimation of Gestational Age in Preterm Infants Abstract • In a study involving 25 preterm infants, obstetric clinical age (standard gestational age) was determined by history, physical examination, and ultrasonographic evaluation. postnatally, these infants were then evaluated using the Dubowitz Scoring System (DSS) for gestational age assessment. The DSS, as administered by us, significantly overestimated gestational age compared with the standard gestational age (mean± SD: 34.2±2.9 vs 32.5±3.9 weeks, respectively) in preterm infants. To illustrate, the gestational ages of 13 newborns (52%) in the total study group were each overestimated by more than two weeks. This percentage increased to 75% among the 16 infants whose gestational ages were less than 34 weeks (by standard gestational age). When the standard gestational age was underestimated by the DSS, this difference never exceeded two weeks. These findings suggest that the present system of postnatal assessment of gestational age in preterm infants needs further investigation. (AJDC 1987;141:1106-1107) References 1. Dubowitz LM, Dubowitz V, Goldberg C: Clinical assessment of gestational age in the newborn infants . J Pediatr 1970;77:1-10.Crossref 2. Ballard JL, Novak KK, Driver M: A simplified score for assessment of fetal maturation of newly born infants . J Pediatr 1979;95:769-774.Crossref 3. Hittner HM, Hirsch NJ, Rudolph AJ: Assessment of gestational age by examination of the anterior vascular capsule of the lens . J Pediatr 1977;91:455-458.Crossref 4. Miller G, Heckmatt JZ, Dubowitz MS, et al: Use of nerve conduction velocity to determine gestational age in infants at risk and in very low birth weight infants . J Pediatr 1983;103:109-112.Crossref 5. Spinnato JA, Sibai BM, Shaver DC, et al: Inaccuracy of Dubowitz gestational age in low birth weight infants . Obstet Gynecol 1984;63: 491-495. 6. Gould JB, Gluck L, Kulovich MV: The relationship between accelerated pulmonary maturity and accelerated neurological maturity in certain chronically stressed pregnancies . Am J Obstet Gynecol 1977;127:181-186. 7. Hadlok FP, Deter RL, Harrist RB, et al: Estimating fetal age: Computer assisted analysis of multiple fetal growth parameters . Radiology 1984;152:497-501.Crossref 8. Kleinbaum DG, Kupper LL: Applied Regression Analysis and Other Multivariate Methods . Boston, Duxbury Press, 1978. 9. Lubchenco LO: Assessment of gestational age and development at birth . Pediatr Clin North Am 1970;17:125-145. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460100084033
Publisher site
See Article on Publisher Site

Abstract

Abstract • In a study involving 25 preterm infants, obstetric clinical age (standard gestational age) was determined by history, physical examination, and ultrasonographic evaluation. postnatally, these infants were then evaluated using the Dubowitz Scoring System (DSS) for gestational age assessment. The DSS, as administered by us, significantly overestimated gestational age compared with the standard gestational age (mean± SD: 34.2±2.9 vs 32.5±3.9 weeks, respectively) in preterm infants. To illustrate, the gestational ages of 13 newborns (52%) in the total study group were each overestimated by more than two weeks. This percentage increased to 75% among the 16 infants whose gestational ages were less than 34 weeks (by standard gestational age). When the standard gestational age was underestimated by the DSS, this difference never exceeded two weeks. These findings suggest that the present system of postnatal assessment of gestational age in preterm infants needs further investigation. (AJDC 1987;141:1106-1107) References 1. Dubowitz LM, Dubowitz V, Goldberg C: Clinical assessment of gestational age in the newborn infants . J Pediatr 1970;77:1-10.Crossref 2. Ballard JL, Novak KK, Driver M: A simplified score for assessment of fetal maturation of newly born infants . J Pediatr 1979;95:769-774.Crossref 3. Hittner HM, Hirsch NJ, Rudolph AJ: Assessment of gestational age by examination of the anterior vascular capsule of the lens . J Pediatr 1977;91:455-458.Crossref 4. Miller G, Heckmatt JZ, Dubowitz MS, et al: Use of nerve conduction velocity to determine gestational age in infants at risk and in very low birth weight infants . J Pediatr 1983;103:109-112.Crossref 5. Spinnato JA, Sibai BM, Shaver DC, et al: Inaccuracy of Dubowitz gestational age in low birth weight infants . Obstet Gynecol 1984;63: 491-495. 6. Gould JB, Gluck L, Kulovich MV: The relationship between accelerated pulmonary maturity and accelerated neurological maturity in certain chronically stressed pregnancies . Am J Obstet Gynecol 1977;127:181-186. 7. Hadlok FP, Deter RL, Harrist RB, et al: Estimating fetal age: Computer assisted analysis of multiple fetal growth parameters . Radiology 1984;152:497-501.Crossref 8. Kleinbaum DG, Kupper LL: Applied Regression Analysis and Other Multivariate Methods . Boston, Duxbury Press, 1978. 9. Lubchenco LO: Assessment of gestational age and development at birth . Pediatr Clin North Am 1970;17:125-145.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1987

References