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Updated: Jun 16, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Predictive performance of the PSU-neonatal early warning score in identifying newborns requiring intensive care
Praenapa Chaithaweesup1, Gunlawadee Maneenil1, Anucha Thatrimontrichai1
1Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Introduction:
The Prince of Songkla University (PSU)-neonatal early warning score (PSU-NEWS) was developed to assist nurses in rapidly assessing the neonatal status and communicating clinical concerns. This study aimed to evaluate the accuracy of the PSU-NEWS in identifying neonates who required non-invasive ventilation (NIV) or admission to the neonatal intensive care unit (NICU).
Methods:
This retrospective study included neonates admitted to a nursery between July 2023 and June 2024. All infants were born at ≥35 weeks' gestation and birth weight ≥1,800 g and were categorized into those transferred to the NICU and those transferred to the postpartum ward. The first and second PSU-NEWS assessments were performed 1-2 h and 4-6 h after birth.
Results:
The first and second PSU-NEWS were assessed in 2,191 and 1,908 neonates, respectively. Of these, 176 required NICU admission and 132 required NIV. In predicting NICU admission, the first PSU-NEWS demonstrated an overall AUC of 0.637 (95% CI: 0.593-0.681). At a cut-off score of ≥2, the receiver operating characteristic (ROC) analysis yielded an AUC of 0.628 with a sensitivity of 47% and specificity of 78%, whereas the second PSU-NEWS showed an overall AUC of 0.755 (95% CI: 0.717-0.792). At a cut-off score of ≥1, the ROC analysis yielded an AUC of 0.751 with a sensitivity of 60% and specificity of 90%. For predicting NIV requirement, the first PSU-NEWS demonstrated an overall AUC of 0.628 (95% CI: 0.575-0.682). At a cut-off score of ≥2, the ROC analysis yielded an AUC of 0.632 with a sensitivity of 48% and specificity of 78%, whereas the second PSU-NEWS showed an overall AUC of 0.785 (95% CI: 0.744-0.826). At a cut-off score of ≥1, the ROC analysis yielded an AUC of 0.783 with a sensitivity of 67% and specificity of 89%.
Conclusions:
The PSU-NEWS demonstrated moderate accuracy in identifying neonates requiring NICU admission or NIV, and the second assessment provided a better predictive performance than the first. Serial scoring may enhance early recognition of infants requiring intensive care.
