Newborn Measurement guide

It is the period or number of weeks that the fetus spends inside the mother’s uterus from the beginning of pregnancy until birth.

Importance of Determining Gestational Age:

- Classification of newborns into full-term, premature, or post-term infants.

- Developing an appropriate treatment plan based on gestational age with early detection and management of possible complications.

- Comparing intrauterine growth of newborns with standard growth rates according to gestational age.

Methods Used to Determine Gestational Age:

Before Birth:

Calculated from the first day of the mother’s last menstrual period or by ultrasound examination.

After Birth:

Using the New Ballard Score, one of the most commonly used methods to determine gestational age during the first hours after birth by assessing neuromuscular and physical maturity.

Conditions:

- The infant should be calm and clinically stable.

- The nurse should record infant data: name, age, examination time, and gestational age.

This assessment includes the following:

1. Posture

The infant’s posture is observed while lying supine, and the score is given according to the closest matching image.

The hand is flexed toward the wrist, and the angle between the palm and the forearm is measured. The score is assigned according to the closest matching image.

The infant is placed in a supine position. The arm is flexed for five seconds, then fully extended and released. The spontaneous flexion of the arm at the elbow is observed. The angle at the elbow joint is assessed, and the score is assigned according to the closest matching image.

The infant is placed supine with the diaper removed, ensuring that the pelvis is flat against the bed. One leg is flexed toward the abdomen until the infant relaxes, then the leg is gently extended. The angle behind the knee is measured, and the score is assigned according to the closest matching image.

The infant is placed supine. One arm is gently pulled across the chest toward the opposite shoulder until resistance is felt. The score is assigned according to the closest matching image.

The infant is placed supine with the pelvis flat against the bed. One foot is gently pulled toward the ear until resistance is felt. The score is assigned according to the closest matching image.

1. Skin

The skin is observed for color, thickness, and transparency of visible veins.

Fine, downy hair present on the forehead, shoulders, arms, back, and legs. It is abundant in preterm infants and minimal or absent in full-term infants.

Male Genitalia

• The total score of neuromuscular and physical maturity is calculated.
• The total score is compared with the maturity rating chart to determine gestational age in weeks.

Fourth: Classification of the Newborn

• Weight (grams), length, and head circumference (centimeters) are measured and recorded.
• Weight, length, and head circumference are compared with gestational age using intrauterine growth charts.
• Newborns are classified according to gestational age and weight for gestational age.

Firstly: According to Gestational Age

Secondly: According to Weight for Gestational Age

Exception in Gestational Age Assessment

If the newborn is clinically unstable during the first hours after birth or affected by maternal sedative medications that interfere with neuromuscular assessment, only the physical maturity score may be calculated and multiplied by two to obtain the total score.
Once the infant becomes more alert and stable within 72 hours, neuromuscular maturity should be reassessed to determine the accurate gestational age.