Comparative Efficacy of New Ballard and Parkin's Scoring Systems for Postnatal Gestational Age Assessment in Neonates: A Prospective Diagnostic Accuracy Study in a Tertiary Care Hospital

The determination of gestational age remains a cornerstone of neonatal clinical practice, particularly in resource-limited settings where prenatal dating is often imprecise or unavailable. This study sought to compare the diagnostic accuracy of the New Ballard Score and the Parkin’s Score in a cohort of 486 neonates at a tertiary care hospital in Rajkot, Gujarat. The primary objective was to evaluate the correlation between these postnatal scoring systems and obstetric gestational age determined by the last menstrual period or first-trimester ultrasonography. The investigation employed a prospective hospital-based design, assessing neonates within the first seven days of life. Findings indicated that while both methods demonstrate a high positive correlation with obstetric gestational age, the New Ballard Score displayed a superior correlation coefficient ($r = 0.939, p < 0.001$) compared to the Parkin’s Score ($r = 0.811, p < 0.001$). Agreement analysis via Cohen’s kappa showed substantial agreement for the New Ballard Score ($\kappa = 0.742$) and moderate agreement for the Parkin’s Score ($\kappa = 0.572$). Notably, the Parkin’s Score, focusing exclusively on four physical parameters—skin texture, skin color, ear firmness, and breast size—offered significant practical advantages in terms of ease of use and reduced interpersonal bias, suggesting its utility as a screening tool for semi-skilled health personnel in environments where complex neurological assessment is unfeasible.