Related Experiment Video
Updated: Mar 8, 2026
Use of a Video Scoring Anchor for Rapid Serial Assessment of Social Communication in Toddlers
Published on: March 14, 2018
Improved SNAPPE-II and CRIB II scores over a 15-year period
F Groenendaal1,2, M C de Vos1, J B Derks1
1Department of Neonatology, Birth Center, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Insights
Illness severity scores for preterm infants decreased over 15 years, with no change in mortality risk. However, morbidity risk declined, improving survival without complications, indicating better neonatal care.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Perinatal Epidemiology
Background:
- Global declines in preterm infant mortality and morbidity have been observed over recent decades.
- Improvements in neonatal intensive care are hypothesized to contribute to better outcomes.
Purpose of the Study:
- To investigate the association between changes in illness severity scores and outcomes in preterm infants over a 15-year period.
- To determine if advancements in care have reduced mortality and morbidity in very preterm infants.
Main Methods:
- Retrospective analysis of inborn infants (gestational age 26+0 to 28+6 weeks) from two cohorts (1997-1999 and 2006-2011).
- Comparison of Score for Neonatal Acute Physiology Perinatal Extension-II (SNAPPE-II) and CRIB II scores, mortality, severe morbidity, and survival without morbidity between periods.
- Multivariable analysis to assess outcomes adjusted for illness severity.
Main Results:
- SNAPPE-II scores significantly decreased in the later period, while CRIB II scores did not change.
- The risk of mortality for given SNAPPE-II and CRIB II scores remained consistent between the two periods.
- The risk of morbidity significantly decreased, and survival without morbidity significantly increased in the later period for comparable illness severity scores.
Conclusions:
- Illness severity assessment scores, specifically SNAPPE-II, have improved for preterm infants over 15 years.
- While mortality risk for similar severity scores has not changed, the risk of morbidity has decreased, leading to better survival without complications.
- These findings highlight significant advancements in obstetrical and neonatal care practices.
Objective:
During the last decades mortality and morbidity of preterm infants have declined in the Western world. We hypothesized that the decrease in mortality in preterm infants was associated with a decrease in illness severity scores (SNAPPE-II and CRIB II scores).
Study Design:
Subjects were inborn infants born between January 1997 and December 1999 (period 1) and between January 2006 and December 2011 (period 2) with a gestational age of 26+0 through 28+6 weeks and without congenital malformations (n=394). SNAPPE-II, CRIB II scores, mortality, severe morbidity and survival without morbidity were recorded. Outcomes between the two periods were analyzed using multivariable analysis.
Results:
SNAPPE-II, but not CRIB II, scores were significantly lower for all GAs in period 2 compared with period 1. The risk of mortality for identical SNAPPE-II scores and CRIB II scores did not differ between the two periods. The risk of morbidity for identical SNAPPE-II scores and CRIB II scores was significantly lower in period 2 versus period 1. Hence, the chance of survival without morbidity for identical SNAPPE-II scores and CRIB II scores increased significantly in period 2 versus period 1.
Conclusions:
SNAPPE-II, but not CRIB II, scores decreased over 15 years. The risk of mortality for identical SNAPPE-II and CRIB II scores did not change, but the risk of morbidity decreased and the chance of survival without morbidity increased for identical SNAPPE-II and CRIB II scores. These findings suggest substantial improvements in both obstetrical and neonatal care.
More Related Videos
Related Concept Videos
01:29Reliability and Validity
01:29Measures of Intelligence
Validity refers to how well a test measures what it claims to measure. An intelligence test should accurately assess intelligence rather than another characteristic, like anxiety. Criterion validity is one way to evaluate this;...