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Updated: Oct 24, 2025
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
86.8K
Comparison of numerical and standard sarnat grading using the NICHD and SIBEN methods
Brian H Walsh1,2, Chelsea Munster3, Hoda El-Shibiny3
1Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland. brianhenry.walsh@ucc.ie.
Summary
The NICHD and SIBEN assessments for neonatal encephalopathy (NE) show good agreement but differ in classifying severity. Both numerical scores effectively predict cerebral injury, outperforming standard grades.
Area of Science:
- Neonatal neurology
- Neurocritical care
- Pediatric neurology
Background:
- Neonatal encephalopathy (NE) is a serious condition requiring accurate severity assessment.
- The NICHD and SIBEN assessments, adapted from the Sarnat grade, are used to determine NE severity.
- Comparing these methods is crucial for understanding their clinical utility in identifying infants at risk for cerebral injury.
Purpose of the Study:
- To compare the NICHD and SIBEN assessment methods for neonatal encephalopathy (NE).
- To evaluate the ability of both methods to define a minimum threshold for significant cerebral injury.
- To assess the agreement and predictive capabilities of NICHD and SIBEN grading systems.
Main Methods:
- A cohort of 145 infants with NE (2016-2019) was analyzed.
- NICHD and SIBEN grading systems and numerical scores were applied.
- Kappa statistics assessed inter-rater agreement, and ROC curves evaluated prediction of MRI-defined injury.
Main Results:
- High agreement was observed between NICHD and SIBEN grading systems (Kappa = 0.86).
- SIBEN classified more infants as moderate NE and fewer as mild NE compared to NICHD (p < 0.001).
- Both numerical scores demonstrated superior ability to predict MRI-defined cerebral injury compared to standard grades.
Conclusions:
- While NICHD and SIBEN show good agreement, SIBEN identifies more moderate NE cases.
- Numerical scores from both systems are effective and comparable in defining thresholds for cerebral injury.
- Further research is needed to compare the long-term outcome prediction of these assessment methods.
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