Narayanan et al developed a simple score for estimating a newborn infant's gestational age based on four physical findings. The authors are from Lady Hardinge Medical College and the Institute of Research and Medical Statistics in New Delhi, India.
Infant selection: first 1-2 days of life
Parameters:
(1) anterior vascular capsule of the lens, using the criteria of Hittner (see previous section)
(2) plantar crease
(3) breast nodule
(4) ear firmness
Parameter
Finding
Points
ocular lens
Grade IV (vascularity extends to center with no clear zone)
0
Grade III (central clearing with vascularity extending into inner third)
1
Grade II (central clearing in central half to two third)
2
Grade I (vascularity limited to outer third of capsule)
4
Grade 0 (no vascularity)
4
plantar crease
no creases
0
faint red marks over anterior half
1
reddish marks over anterior half; definite creases over anterior third
2
creases over more than anterior third
3
creases all over; deep indentations over anterior third
4
breast nodule
no breast tissue palpable
0
nodule on one or both sides < 0.5 cm
1
nodule on one or both sides 0.5 – 1.0 cm
2
nodule on one or both sides > 1.0 cm
3
ear firmness (pinna)
extremely soft
0
soft along the edge; easily folded with slow recoil
1
some cartilage but thin at places; ready recoil if folded
2
stiffened by cartilage up to the periphery; immediate recoil if folded
3
total score =
= SUM(points for all 4 parameters)
Total Score
Gestational Age in Weeks
1
28
2
29
3
29.5
4
30.5
5
31
6
32
7
33
8
34
9
35
10
36
11
37
12
38
13
39
14
40
Performance:
• The 95% confidence interval was +/- 11 days.
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