Related Experiment Video
Updated: Sep 7, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A Systematic Review of Antenatal Risk Scoring Systems in India to Predict Adverse Neonatal Outcomes
Dinesh Raj Pallepogula1, Adhisivam Bethou1, Vishnu Bhat Ballambatu2
1Department of Neonatology, JIPMER Puducherry, Puducherry, India.
Insights
Indian antenatal scoring systems show high sensitivity but low specificity for predicting adverse neonatal outcomes. A systematically developed system is needed to improve mother and child health programs.
Area of Science:
- Maternal Health
- Neonatal Outcomes
- Public Health Interventions
Background:
- Antenatal care (ANC) aims to identify high-risk pregnancies and optimize resource allocation.
- Antenatal scoring systems are used globally to manage synergistic risk factors.
- Predicting adverse neonatal outcomes is crucial for effective maternal and child health.
Purpose of the Study:
- To systematically review antenatal risk scoring systems developed and utilized in India.
- To evaluate the effectiveness of these systems in predicting adverse neonatal outcomes.
Main Methods:
- Systematic review of articles published between January 2000 and April 2020.
- Searched multiple databases including Embase, MEDLINE/PubMed, and Cochrane Library.
- Assessed study quality using the Prediction model study Risk Of Bias Assessment Tool (PROBAST).
Main Results:
- Six studies were identified, with one developing a new system and five using existing ones.
- The developed scoring system exhibited a high risk of bias and concerns regarding applicability.
- Overall sensitivity was high (77.4%), but specificity (45%), positive predictive value (15.3%), and negative predictive value (94.2%) varied.
Conclusions:
- Existing antenatal scoring systems in India have limitations in predicting adverse neonatal outcomes.
- There is a critical need for a systematically developed and validated antenatal scoring system for the Indian population.
- Such a system could significantly enhance the implementation of mother and child health programs.
Background:
The purpose of antenatal care (ANC) is to identify 'at-risk' pregnant women, to provide quality care for all, and maximize the allocation of resources for those who need them the most. To address the synergistic effect of risk factors, clinicians across the globe developed antenatal scoring systems.
Objective:
This review aims to investigate various antenatal risk scoring systems developed and used in India to predict adverse neonatal outcome.
Methods:
We reviewed articles published between January 2000 and April 2020, which have either developed a scoring system or used a scoring system, among the Indian population. This systematic review is reported based on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Prediction model study Risk Of Bias Assessment Tool (PROBAST) was employed for the assessment of the quality of included studies. Data sources such as Embase, MEDLINE/Pubmed, APA PsycExtra, PsycINFO, CINHAL Plus, Cochrane Library, IndMED, LILACS, Scopus, WHO Reproductive Health Library and Web of science were searched.
Results:
An initial search retrieved a total of 6246 articles. This systematic review identified six studies, of which one study developed an antenatal scoring system and the other five studies used two antenatal systems for predicting adverse neonatal outcome. The study which developed a risk scoring system had a high risk of bias (ROB) and concern for applicability. The overall sensitivity of the antenatal scoring system was high (77.4%), but the specificity was low (45%). Similarly, the positive predictive value is low (15.3%), and the negative predictive value is high (94.2%). A meta-analysis was not conducted due to the heterogeneity of the studies and insufficient data.
Conclusions:
There is a need for a systematically developed antenatal scoring system for India. Such scoring systems can be promising in public health, proposing a paradigm shift in the implementation of effective mother and child health programmes locally as well as nationally.
Supplementary Information:
The online version contains supplementary material available at 10.1007/s13224-021-01484-z.
Related Concept Videos
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT