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

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 an 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 the gold standard. Methods: This cross-sectional study was conducted among 1114 intramural neonates who qualified according to the selection criteria. All neonates were evaluated using the three scores by residents (blinded to USG-GA) with a pre-defined inter-observer difference of <10%. Method applicability was compared in terms of accuracy, precision and validity. Results: GA was systematically overestimated by 0.65, 0.68 and 0.32 weeks by ENBS, PS and ES, respectively. For GA subgroups, ES had better overall accuracy with mean difference of 0.3260.88 weeks. Validity was highest for ES (79.6%). Interpretation: We conclude that all three scores were found to be of acceptable accuracy and validity. ES had better overall accuracy and validity among the subjects and for subgroups. In limited resource settings, ES or PS can substitute for ENBS.