Allan Rachel C, Sayers Susan, Powers Jennifer, Singh Gurmeet
Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Northern Territory, Australia.
J Paediatr Child Health. 2009 Jan-Feb;45(1-2):15-9. doi: 10.1111/j.1440-1754.2008.01429.x.
The aims of this study were to develop and evaluate a shorter gestational age estimation method based on the Dubowitz scoring system (DSS) that could be taught easily to untrained health-care workers.
Using the DSS, seven criteria were identified that explained 90% of the variance in gestational age estimation. Ventral suspension was excluded, skin texture was substituted for skin colour and ear bending was for ear firmness. The final six criteria comprise the short DSS (SDSS). The study population was 100 babies, 51 Caucasian, 34 Aboriginal. Birth weight ranged from 1351 to 5430 g. The gestational age range was 29.6-41.7 weeks. Three researchers (medical student 1 (MS1), medical student 2 (MS2) and a paediatrician) who were blind to other available gestational age estimations assessed babies within 72 h of birth using the DSS and SDSS.
MS1 found the 95% limits of agreement (LOA) between SDSS and DSS to be -1.1 to 1.7 weeks. In the 27 babies who had first trimester foetal ultrasound (USS), the LOA between USS and SDSS were -1.9 to 1.4 weeks and -2.3 to 1.9 weeks, respectively. Using the SDSS, the LOA for the three researchers were within +/-2 weeks.
The data presented suggest that the SDSS is approximately equivalent to the DSS in the relatively limited population studied, and within these limitations appears to be a simple alternative to the DSS. Further evaluation is needed before firm conclusions about the accuracy and clinical utility of the SDSS can be made.
本研究的目的是开发并评估一种基于杜波维茨评分系统（DSS）的更短孕周估计方法，该方法可以轻松传授给未经培训的医护人员。
使用DSS，确定了七个标准，这些标准解释了孕周估计中90%的方差。排除腹悬，用皮肤纹理替代皮肤颜色，用耳弯曲替代耳硬度。最终的六个标准构成了简短DSS（SDSS）。研究人群为100名婴儿，其中51名高加索人，34名原住民。出生体重范围为1351至5430克。孕周范围为29.6 - 41.7周。三名对其他可用孕周估计不知情的研究人员（医学生1（MS1）、医学生2（MS2）和一名儿科医生）在婴儿出生后72小时内使用DSS和SDSS对其进行评估。
MS1发现SDSS和DSS之间的95%一致性界限（LOA）为-1.1至1.7周。在27名有孕早期胎儿超声（USS）检查的婴儿中，USS和SDSS之间的LOA分别为-1.9至1.4周和-2.3至1.9周。使用SDSS时，三名研究人员的LOA在±2周内。
所呈现的数据表明，在研究的相对有限人群中，SDSS与DSS大致相当，并且在这些限制范围内似乎是DSS的一种简单替代方法。在能够对SDSS的准确性和临床实用性得出确凿结论之前，还需要进一步评估。
