Determining Gestational Age in a Low-resource Setting: Validity of Last Menstrual Period

Authors

  • Rebecca E Rosenberg Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • ASM Nawshad U Ahmed Department of Neonatalogy, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka 1207
  • Saifuddin Ahmed Department of Population and Family Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • Samir K Saha Department of Microbiology, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka 1207
  • MAK Azad Chowdhury Department of Neonatalogy, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka 1207
  • Robert E Black Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • Mathuram Santosham Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
  • Gary L Darmstadt Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD

DOI:

https://doi.org/10.3329/jhpn.v27i3.3375

Keywords:

Gestational age, Last menstrual period, Neonatal health, Obstetrics, Bangladesh

Abstract

The validity of three methods (last menstrual period [LPM], Ballard and Dubowitz scores) for assessment of gestational age for premature infants in a low-resource setting was assessed, using antenatal ultrasound as the gold standard. It was hypothesized that LMP and other methods would perform similarly in determin­ing postnatal gestational age. Concordance analysis was applied to data on 355 neonates of <33 weeks ges­tational age enrolled in a topical skin-therapy trial in a tertiary-care children's hospital in Bangladesh. The concordance coefficient for LMP, Ballard, and Dubowitz was 0.878, 0.914, and 0.886 respectively. LMP and Ballard underestimated gestational age by one day (±11) and 2.9 days (±7.8) respectively while Dubowitz overestimated gestational age by 3.9 days (±7.1) compared to ultrasound finding. LMP in a low-resource setting was a more reliable measure of gestational age than previously thought for estimation of postnatal gestational age of preterm infants. Ballard and Dubowitz scores are slightly more reliable but require more technical skills to perform. Additional prospective trials are warranted to examine LMP against antenatal ultrasound for primary assessment of neonatal gestational age in other low-resource settings.

Key words: Gestational age; Last menstrual period; Neonatal health; Obstetrics; Bangladesh

doi: 10.3329/jhpn.v27i3.3375

J Health Popul Nutr 2009 Jun;27(3):332-338

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Author Biographies

ASM Nawshad U Ahmed, Department of Neonatalogy, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, Dhaka 1207

Department of Paediatrics, Kumudini Women's Medical College, Mirzapur, Tangail, Bangladesh

Gary L Darmstadt, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD

Dr. Gary L. Darmstadt
Integrated Health Solutions Development
Global Health Program
Bill & Melinda Gates Foundation
PO Box 23350
Seattle, WA 98102
Email: gary.darmstadt@gatesfoundation.org
Cover JHPN Vol.27(3)

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How to Cite

Rosenberg, R. E., Ahmed, A. N. U., Ahmed, S., Saha, S. K., Chowdhury, M. A., Black, R. E., Santosham, M., & Darmstadt, G. L. (2009). Determining Gestational Age in a Low-resource Setting: Validity of Last Menstrual Period. Journal of Health, Population and Nutrition, 27(3), 332–338. https://doi.org/10.3329/jhpn.v27i3.3375

Issue

Vol. 27 No. 3 (2009)

Section

Original Papers