Fenton Preterm Growth Chart for Boys

Length
Head Circumference

Weight

Gestational age (weeks)

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Name Date of Birth Record #

Date Size for Gestational Age
Age in Weeks SGA
Length
AGA
Head Circumference
Weight LGA
MATURATIONAL ASSESSMENT OF GESTATIONAL AGE (New Ballard Score)
NAME SEX
HOSPITAL NO. BIRTH WEIGHT
RACE LENGTH
DATE/TIME OF BIRTH HEAD CIRC.
DATE/TIME OF EXAM EXAMINER
AGE WHEN EXAMINED

APGAR SCORE: 1 MINUTE 5 MINUTES 10 MINUTES

NEUROMUSCULAR MATURITY
SCORE
SCORE RECORD
NEUROMUSCULAR SCORE Neuromuscular
MATURITY SIGN -1 0 1 2 3 4 5 HERE Physical
Total

POSTURE
MATURITY RATING

SQUARE SCORE WEEKS

WINDOW
(Wrist) >90° 90° 60° 45° 30° 0° -10 20

ARM RECOIL -5 22
180° 140 –180° 110 –140° 90 –110° <90° 0 24

POPLITEAL ANGLE 5 26
180° 160° 140° 120° 100° 90° <90°
10 28

SCARF SIGN 15 30

20 32
HEEL TO EAR
25 34
TOTAL NEUROMUSCULAR
MATURITY SCORE 30 36

PHYSICAL MATURITY 35 38
SCORE RECORD
PHYSICAL SCORE 40 40
MATURITY SIGN -1 0 1 2 3 4 5 HERE
45 42
sticky gelatinous superficial cracking parchment leathery
smooth pink
SKIN friable red peeling & / or pale areas deep cracking cracked 50 44
visible veins
transparent translucent rash, few veins rare veins no vessels wrinkled

LANUGO none sparse abundant thinning bald areas mostly bald GESTATIONAL AGE
(weeks)
By dates
heel-toe >50 mm faint anterior creases creases over By ultrasound
PLANTAR 40–50 mm: -1 no crease red marks transverse ant. 2/3 entire sole By exam
SURFACE < 40 mm: -2 crease only

barely flat areola stippled areola raised areola full areola

BREAST imperceptible
perceptible no bud 1–2 mm bud 3–4 mm bud 5–10 mm bud

lids fused lids open sl. curved well-curved

EYE / EAR loosely: -1 pinna flat pinna; soft; pinna; soft but formed & firm thick cartilage
tightly: -2 stays folded slow recoil ready recoil instant recoil ear stiff

testes in testes testes

GENITALS scrotum flat, scrotum empty testes down
(Male) upper canal descending pendulous
smooth faint rugae rare rugae few rugae good rugae deep rugae
clitoris prominent prominent majora & majora cover
GENITALS clitoris & majora large
(Female) prominent clitoris & small enlarging minora equally
minora small clitoris
& labia flat labia minora minora prominent & minora

Reference TOTAL PHYSICAL

Ballard JL, Khoury JC, Wedig K, et al: New Ballard Score, expanded to include extremely premature infants.
J Pediatr 1991; 119:417– 423. Reprinted by permission of Dr Ballard and Mosby–Year Book, Inc.
MATURITY SCORE

Provided as a public service from Abbott Nutrition.

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