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Updated: Aug 12, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Multistage scoring system for identifying infants at risk of unexpected death
Insights
This study developed scoring systems to identify high-risk infants at birth and one month. A multistage scoring system demonstrated improved effectiveness in predicting infant mortality risk.
Area of Science:
- Perinatal Medicine
- Neonatology
- Public Health
Background:
- Infant mortality remains a significant public health concern.
- Early identification of high-risk infants is crucial for timely intervention.
- Existing methods for risk assessment at birth may require enhancement.
Purpose of the Study:
- To develop and validate scoring systems for identifying high-risk infants at birth and one month of age.
- To compare the effectiveness of different scoring systems in predicting infant mortality.
- To provide a tool for improved perinatal and neonatal risk stratification.
Main Methods:
- Assembled obstetric and perinatal records for 250 infant deaths and 250 live controls.
- Included cases with congenital anomalies and interviewed parents of a subset.
- Abstracted comprehensive health service records and developed 'at birth' and one-month scoring systems.
Main Results:
- Developed and presented 'at birth' and combined (birth and one-month) scoring systems.
- Demonstrated the chance of death by attained age for various risk groups.
- A multistage scoring system showed nearly 50% greater effectiveness than the birth score alone in a prospective test.
Conclusions:
- Scoring systems based on perinatal data can effectively identify high-risk infants.
- A combined or multistage approach offers superior predictive power for infant mortality.
- These tools can aid in targeted neonatal care and resource allocation.
Abstract:
Obstetric and perinatal records have been assembled on 250 infant deaths and an equal number of live controls including 55 deaths associated with congenital anomalies. The information was used to construct a scoring system to identify high-risk infants at birth. Parents of 115 of the cases and their controls were also interviewed and all hospital, general practitioner, and health service records abstracted. Cases and controls were compared item by item in respect of all information available up to the age of one month and a scoring system constructed for use at one month. The 'at birth' and combined scoring systems are presented. The chance of death by age attained is presented for various risk groups. In a small prospective test, the multistage scoring system was nearly 50% more effective than the birth score alone.
