OBJECTIVE: Our objective was to determine whether the Ballard score, a maturity score for neonatal neuromuscular and physical development, is more advanced in preterm infants of preeclamptic women than in controls. STUDY DESIGN: A matched cohort study design was used. One hundred women with strictly defined preeclampsia (new-onset hypertension, proteinuria, and hyperuricemia) were matched for gestational age, race, and gender to 100 normotensive women with preterm delivery. All patients had an assigned antenatal gestational age based on ultrasonography before 24 weeks. The gestational age, based on antenatal ultrasonography and last menstrual period, was compared with the Ballard score given at the time of the neonatal physical examination within the first 12 hours after delivery. The difference in gestational age between the Ballard score and antenatal ultrasonography (Ballard score - ultrasonography) was calculated for each patient. Results are expressed as median and range and are compared with a Student t test. RESULTS: The mean gestational age at delivery by antenatal ultrasonography in patients with severe preeclampsia was 32.06 ± 2.74 and 32.03 ± 2.70 weeks, respectively. The median difference between scores in patients with severe preeclampsia and normal patient were 1.3 ± 1.8 and 1.5 ± 1.6 weeks, respectively (p = 0.41). CONCLUSION: On the basis of criteria defined by the Ballard score, preeclampsia was not associated with accelerated fetal neurologic and physical development. (AM J OBSTET GYNECOL 1996;174:829-32.)