Updating a Perinatal Risk Scoring System to Predict Infant Mortality

Area of Science:

• Public Health
• Biostatistics
• Pediatrics

Background:

• The Birth Score Project in West Virginia (WV) has aimed to identify at-risk newborns since 1984.
• Infant mortality remains a critical public health concern, necessitating updated risk assessment tools.

Purpose of the Study:

• To update the existing Birth Score using current literature and advanced statistical methods.
• To enhance the prediction of infant mortality risk in newborns.

Main Methods:

• Merged data from Birth Score, Birth Certificate (2008-2013), and Infant Mortality records (N=121,640).
• Data split into developmental (N=85,148) and validation (N=36,492) sets.
• Developed a weighted multivariate risk score incorporating infant and maternal factors.

Main Results:

• The updated score ranges from 0 to 86.
• A high score (≥17) identified 18.1% of infants (n=15,387).
• Infants with a high score had 5.6 times higher odds of mortality (95% CI: 4.4, 7.1).

Conclusions:

• The updated Birth Score demonstrates superior predictive accuracy for infant mortality compared to the previous version.
• This revised score offers practical utility for WV physicians to identify high-risk infants.
• Facilitates timely referral to pediatric services and case management for enhanced infant follow-up.