Paediatrics Neonatology Standard — Ballard 1991

Ballard Maturational Assessment

Estimates gestational age in newborns based on neuromuscular and physical maturity criteria. New Ballard Score (NBS) validated from 20–44 weeks.

Score interpretation

Extremely Premature (20–24 weeks) 0–10

Ballard Score 0–10: Estimated gestation 20–24 weeks. Periviable.

→ Neonatology / NICU. Antenatal corticosteroids if not delivered. Parental counselling on viability and outcomes.

Very Premature (25–28 weeks) 11–20

Ballard Score 11–20: Estimated gestation 25–28 weeks.

→ NICU care. Surfactant replacement. Respiratory support. IVH screening USS. TPN. Temperature regulation.

Premature (29–33 weeks) 21–30

Ballard Score 21–30: Estimated gestation 29–33 weeks.

→ SCBU/NNU care. Monitor feeding, temperature, glucose, bilirubin. Apnoea monitoring.

Late Preterm / Early Term (34–38 weeks) 31–40

Ballard Score 31–40: Estimated gestation 34–38 weeks.

→ Close monitoring for feeding difficulties, jaundice, temperature instability. Transition support.

Term (39–44 weeks) 41–50

Ballard Score 41–50: Estimated gestation 39–44 weeks. Term neonate.

→ Routine neonatal check. Newborn screening. Feeding support.

Interpretation bands for the Ballard Score. Apply clinical judgement and local guidance.

Ballard JL et al. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.