Use this score sheet to assess the gestational maturity of your baby. At the end of the examination the total score determines the gestational maturity in weeks.

NEUROMUSCULAR MATURITY :

SIGN	SCORE							SIGN SCORE
	-1	0	1	2	3	4	5
Posture
Square Window
Arm Recoil
Popliteal Angle
Scarf Sign
Heel To Ear
TOTAL NEUROMUSCULAR SCORE

  PHYSICAL MATURITY :                        

SIGN	SCORE							SIGN SCORE
	-1	0	1	2	3	4	5
Skin	Sticky, friable, transparent	gelatinous, red, translucent	smooth pink, visible veins	superficial peeling &/or rash, few veins	cracking, pale areas, rare veins	parchment, deep cracking, no vessels	leathery, cracked, wrinkled
Lanugo	none	sparse	abundant	thinning	bald areas	mostly bald
Plantar Surface	heel-toe 40-50mm: -1 <40mm: -2	>50 mm no crease	faint red marks	anterior transverse crease only	creases ant. 2/3	creases over entire sole
Breast	imperceptable	barely perceptable	flat areola no bud	stippled areola 1-2 mm bud	raised areola 3-4 mm bud	full areola 5-10 mm bud
Eye / Ear	lids fused loosely: -1 tightly: -2	lids open pinna flat stays folded	sl. curved pinna; soft; slow recoil	well-curved pinna; soft but ready recoil	formed & firm instant recoil	thick cartilage ear stiff
Genitals (Male)	scrotum flat, smooth	scrotum empty, faint rugae	testes in upper canal, rare rugae	testes descending, few rugae	testes down, good rugae	testes pendulous, deep rugae
Genitals (Female)	clitoris prominent & labia flat	prominent clitoris & small labia minora	prominent clitoris & enlarging minora	majora & minora equally prominent	majora large, minora small	majora cover clitoris & minora
TOTAL PHYSICAL MATURITY SCORE

MATURITY RATING :

TOTAL SCORE  (NEUROMUSCULAR + PHYSICAL)	WEEKS
-10	20
-5	22
0	24
5	26
10	28
15	30
20	32
25	34
30	36
35	38
40	40
45	42
50	44

            Figure 86.2-3 Neuromuscular criteria for maturity. The expanded New Ballard Score includes extremely premature infants and has been refined to improve accuracy in more mature infants. (From Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature infants. J Pediatr 1991;119:417.)

Behrman: Nelson Textbook of Pediatrics, 17th ed., Copyright © 2004 Elsevier

Figure 86.2-2 Physical criteria for maturity. The expanded New Ballard Score includes extremely premature infants and has been refined to improve accuracy in more mature infants. (From Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature infants. J Pediatr 1991;119:417.)

Figure 86.2-4 Maturity rating. The physical and neurologic scores are added to calculate gestational age. (From Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature infants. J Pediatr 1991;119:417.)