Agreement between pediatrician and trained paramedic in the assessment of gestational age among newborns using New Ballard Scored

Abstract

Accurate gestational age assessment is important in newborn examination to determine further management. One
of methods to estimate newborn gestation is New Ballard Score (NBS). With limited number of pediatrician especially
in remote areas, it is expected trained paramedic will be able to perform NBS examination properly. The aim of this
study was to assess whether there is agreement between pediatricians and trained paramedics in determining
newborn gestational age using NBS. This was a cross sectional study. Ballard scoring was performed by pediatricians
and trained paramedics in Dentatama Mother and Child Hospital, Sragen Distric, Central Java, Indonesia from
February-May 2008. Statistical analysis was performed using intraclass correlation. This study was performed in
175 newborns those consisted of 55.4% males and 44.6% females. From those newborns, 30.3% were delivered
by caesarian section, and 10.3% were premature baby. Majority of Ballard score examination (69.7%) was performed
in 2nd day. According to intraclass correlation, there was a very strong correlation agreement between pediatricians
and trained paramedics (r=0.925 and p<0.05). The result of Ballard score examination that close to gold standard
those which were performed at 48-96 hours of age (r=0.993 and p<0.05). In conclusion, there was a good
agreement between pediatricians and trained paramedics in assessing newborn gestational age using NBS.
Key words: Ballard score - trained paramedic - newborn – pedriatician - hospital