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Updated: Apr 28, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predicting the Outcome of Sick Neonates Using the Sick Neonate Score: A Prospective Observational Study
Mohd Ashraf1, Asma Wani2, Parvez Ahmed3
1Pediatric Nephrology, Government Medical College, Srinagar, IND.
Background:
At the critical transition from intrauterine to extrauterine life, prompt and precise management by the healthcare team is of immense importance. Neonatal transport services play a vital role during this period. The aim of this study was to evaluate the association between the Sick Neonate Score (SNS) and mortality among extramural neonates admitted to the neonatal ICU (NICU).
Methods:
This prospective observational study was conducted from November 2019 to October 2021. All extramural neonates admitted to the NICU were enrolled, excluding those with surgical conditions, congenital anomalies, or syndromic features. Demographic details of the neonate and mother, indications for referral, mode of transport, and the presence of accompanying trained personnel were documented. Each neonate was followed until discharge or death. The condition at arrival was assessed, and the SNS was used to predict outcomes.
Results:
A total of 422 neonates met the inclusion criteria, with a mortality rate of 115 (27.3%). The most common reasons for referral were respiratory distress syndrome 119 (28.2%), hyperbilirubinemia 91 (21.6%), and sepsis 84 (19.9%). The SNS demonstrated high predictive value for mortality, with a sensitivity of 106/115 (91.3%), specificity of 254/307 (82.7%), and an area under the receiver operating characteristic (ROC) curve (AUC) of 0.913. A cut-off score of ≤7 was associated with a significantly poorer prognosis compared to scores >7.
Conclusion:
The SNS is simple to comprehend, easy to use, and requires minimal technology or expertise.
