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Software

This version was machine-translated from German and has not been medically reviewed. The authoritative version is the German version.

New Ballard Score

Gestational age from neuromuscular and physical maturity (Ballard 1991), 20–44 weeks

Child

Sex

male female

Posture (Posture)

Shown in the original only as a pictogram; the description reproduces the illustration.

Arms and legs extended 0 slight flexion of hips and knees 1 greater flexion of legs, arms extended 2 Arms slightly flexed, legs flexed and abducted 3 Arms and legs fully flexed 4

Wrist angle (Square Window)

above 90° -1 90° 0 60° 1 45° 2 30° 3 0° 4

Arm recoil

180° (no springing back) 0 140–180° 1 110–140° 2 90–110° 3 below 90° 4

Popliteal angle

180° -1 160° 0 140° 1 120° 2 100° 3 90° 4 below 90° 5

Scarf sign

Shown in the original only as a pictogram; the description reproduces the illustration.

Elbow reaches the opposite shoulder -1 Elbow crosses the opposite anterior axillary line 0 Elbow reaches the opposite anterior axillary line 1 Elbow reaches the midline 2 Elbow does not reach the midline 3 Elbow does not cross the ipsilateral axillary line 4

Heel to ear

Shown in the original only as a pictogram; the description reproduces the illustration.

Heel reaches the ear, leg extended -1 Heel near the ear 0 Heel does not quite reach shoulder level 1 Heel to chest level, knee slightly flexed 2 Heel to abdominal level, knee clearly flexed 3 Heel stays below the hip, knee strongly flexed 4

Skin

sticky, friable, transparent -1 gelatinous, red, translucent 0 smooth pink, visible veins 1 superficial peeling and/or rash, few veins 2 cracked, pale areas, occasional veins 3 parchment-like, deep cracks, no vessels 4 leathery, cracked, wrinkled 5

Lanugo

none -1 sparse 0 abundant 1 thinning 2 bald patches 3 predominantly bald 4

Sole of the foot

Heel–toe under 40 mm -2 Heel–toe 40–50 mm, no crease -1 above 50 mm, no fold 0 pale red lines 1 anterior transverse crease only 2 Creases over the anterior two thirds 3 Creases over the entire sole 4

Mammary gland

imperceptible -1 barely perceptible 0 flat areola, no bud 1 speckled areola, bud 1–2 mm 2 raised areola, bud 3–4 mm 3 full areola, bud 5–10 mm 4

Eye / ear

Eyelids firmly fused -2 Eyelids loosely fused -1 Eyelids open; pinna flat, stays folded 0 Pinna slightly curved, soft, slow recoil 1 well curved, soft, springs back readily 2 formed and firm, springs back immediately 3 thick cartilage, ear stiff 4

Genitalia (male)

Scrotum flat, smooth -1 Scrotum empty, faint rugation 0 Testes in the upper inguinal canal, sparse rugation 1 Testes descending, few rugae 2 Testes in the scrotum, good rugation 3 Testes hanging, deep rugae 4

Genitalia (female)

Clitoris prominent, labia flat -1 Clitoris prominent, small labia minora 0 Clitoris prominent, labia minora becoming larger 1 Labia majora and minora equally prominent 2 Labia majora large, minora small 3 Labia majora cover clitoris and minora 4

Scientific basis

Time point

Validated for examinations 0.2–96 hours after birth at 20–44 weeks; for children under 26 weeks, preferably within the first 12 hours.

Calculation aid for healthcare professionals: the calculator reproduces what the sources cited assign to the inputs. Clinical assessment and every treatment decision remain with the treating physician. Inputs and results are not stored.

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Sources

New Ballard Score, expanded to include extremely premature infants (J Pediatr 119:417–423) Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R, 1991. Original paper (reprint freely available at ballardscore.com)
The New Ballard Score – official score sheet with maturity rating ballardscore.com, 1991. Score sheet
Frequently Asked Questions – Score Calculation (interpolation to completed weeks) Ballard JL (ballardscore.com). Author's explanation of the score sheet

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Note

Calculation aid for healthcare professionals. Clinical assessment remains with the treating physician.

Review date of the German original: 2026-11-05 · Methodology

Frequently asked questions

New Ballard Score: What does this calculator compute?

Estimates gestational age from six neuromuscular and six physical maturity signs according to the New Ballard Score (Ballard 1991): sum −10 to 50 points, conversion via the maturity rating (−10 → 20 weeks … 50 → 44 weeks).

New Ballard Score: Which sources is this calculator based on?

Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R: New Ballard Score, expanded to include extremely premature infants (J Pediatr 119:417–423) (1991); ballardscore.com: The New Ballard Score – official score sheet with maturity rating (1991); Ballard JL (ballardscore.com): Frequently Asked Questions – Score Calculation (interpolation to completed weeks)