DUBOWITZ ASSESSMENT OF GESTATIONAL-AGE AND AGREEMENT WITH PRENATAL METHODS

We compared assessment of gestational age by Dubowitz score with ultra sonic measurement of the biparietal diameter (BPD), and then evaluated how infants were classified by these methods as small-for-gestational age (SGA), and as pre- or post-term births. BPD gestational age was a ssessed at week 17 to 20 of pregnancy while the Dubowitz scoring was d one at birth. ''Limits of agreement'' between methods and kappa values were calculated and used to evaluate agreement. Among 839 included in fants, there was moderate agreement between Dubowitz score and BPD (li mits of agreement; -2.3; +2.1 weeks; weighted kappa: 0.46) in the asse ssment of gestational age. Agreement between Dubowitz score and DPD in the classification of SGA (kappa: 0.75, 95% confidence interval [CI]: 0.69-0.81) and preterm infants (kappa: 0.68, 95% CI: 0.56-0.80) was g ood, whereas agreement on infants born post-term was no better than ch ance (kappa: 0.14, 95% CI: -0.02 -+0.30). We conclude that despite mod erate agreement between Dubowitz score and BPD in the assessment of ge stational age, agreement in the classification of low-birth-weight inf ants as SCA and as premature births was good.