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Estimating gestational age from a newborn relies on assessing maturity through a scoring system that assigns points to a set of clinical signs. The Dubowitz scoring method uses 21 defined signs to gauge both physical and neuromuscular maturity. It breaks down into physical maturity (skin texture, lanugo, plantar creases, breast tissue, eye/ear complexity, and genitalia) and neuromuscular maturity (signs such as square window, arm recoil, popliteal angle, scarf sign, and heel-to-ear). Adding the points from all these signs gives a gestational age estimate with finer granularity than methods that use fewer criteria.

In contrast, the Apgar score measures immediate newborn condition at 1 and 5 minutes after birth rather than gestational age. The Ballard score, while also a maturity assessment, uses fewer signs (about 12), making it less detailed than the Dubowitz system. Lund and Gingerich is another older assessment but is not the 21-sign Dubowitz method.