New Ballard Score has been shown to exceed actual gestational age for infants less than 28 weeks gestation by:

• A. 2-4 days
• B. 5-7 days
• C. 1-3 weeks
• D. 4-6 weeks

Answer: (C)

The main idea is that the New Ballard Score, while useful for estimating gestational age from postnatal maturity, tends to overestimate the actual gestational age in extremely preterm infants. For newborns born before 28 weeks, research shows this scoring method can indicate a maturity level that corresponds to about one to three weeks more than their true gestational age. This happens because the maturity markers used in the score are less precise at the very earliest ages, and postnatal factors can influence how those signs present, leading to a systematic slight overestimation. Clinically, this means that if you’re evaluating an infant under 28 weeks, you should corroborate NBS findings with prenatal ultrasound dating or other dating information, recognizing that the score may skew toward a gestational age higher by roughly one to three weeks.