Ballard Maturational Assessment (New Ballard Score)

When it activates

Scribeable activates a calculator from the encounter. The Ballard Maturational Assessment (New Ballard Score) can activate when the transcript or pasted chart context documents any of these:

• Gestational age assessment
• Neonatal maturity evaluation
• Uncertain gestational dating
• Preterm infant assessment
• Newborn gestational age estimation

Inputs the note needs

3 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.

Scoring

Neuromuscular maturity (6 items, each -1 to 4 or 5): posture, square window, arm recoil, popliteal angle, scarf sign, heel to ear. Physical maturity (6 items, each -1 to 4 or 5): skin, lanugo, plantar surface, breast, eye/ear, genitals. Total = neuromuscular + physical. Score-to-age mapping: -10=20wk, -5=22wk, 0=24wk, 5=26wk, 10=28wk, 15=30wk, 20=32wk, 25=34wk, 30=36wk, 35=38wk, 40=40wk, 45=42wk, 50=44wk.

Interpretation

Best performed within first 48 hours of life (accuracy decreases after 96 hours). Accuracy: +/- 2 weeks. Extremely preterm (<28wk) assessment less reliable. New Ballard Score expanded to include extremely premature infants (20-26 weeks). Discrepancy between Ballard and OB dating >2 weeks warrants clinical correlation. Physical maturity components more reliable in extremely preterm; neuromuscular more reliable in term/near-term.

Evidence

Sources carried in Scribeable's citation registry for this calculator; guideline version: Ballard 1991.

• Ballard JL et al. New Ballard Score, expanded to include extremely premature infantsBallard et al. (New Ballard) 1991 · 1991 · link last verified 2026-03-28

How Scribeable handles it in the note

When an encounter activates the Ballard Maturational Assessment (New Ballard Score) (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.

The score is computed in code from the resolved inputs, not recalled by the language model. A stated Ballard Maturational Assessment (New Ballard Score) value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.

Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.

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Can activate in: Pediatrics, OB/GYN, Neonatology.