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Updated: Aug 11, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Development and Internal Validation of Neonatal Outcomes Prediction Score (NOPS) and Model for Neonates of 22-29
Prakesh S Shah1, Soutrik Seth1, Seungwoo Lee1
1Department of Paediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada.
Objective:
To develop and internally validate models and severity scores at days 7, 14, and 28 to predict death, major morbidity, and bronchopulmonary dysplasia in 22-29 weeks' gestation neonates.
Study Design:
This retrospective cohort study included infants admitted to Canadian neonatal intensive care units (2010-2023) and used 16 predefined baseline, intervention, and morbidity variables to develop prediction models and the Neonatal Outcomes Prediction Score (NOPS) at days 7, 14, and 28. Infants transferred to level 2 units before model age were excluded.
Results:
We studied 26,719 infants of 22-29 weeks' gestation (median GA=27 weeks, median birthweight 980 g). Eleven variables for outcome of death, 8 for death/major morbidity, 7 for death/bronchopulmonary dysplasia, and 8 for death/moderate-severe BPD were associated with respective outcomes in three time-based models. The models were internally valid. The AUC for death were >0.85, death/major morbidity were >0.80, death/bronchopulmonary dysplasia were >0.78 and death/moderate-severe BPD were >0.76 at all timepoints. The NOPS derived from these models showed that a score >30 was significantly associated with all three outcomes, with ORs >8.3 at all timepoints.
Conclusions:
An internally valid and accurate models for neonatal outcome prediction in the first postnatal weeks were generated including static variables, exposed interventions, and accumulated morbidities. NOPS >30 was significantly associated with all 4 outcomes at all timepoints. The models require external validation.