Comparison of six neonatal mortality prediction scores: A prospective observational study

doi:10.5409/wjcp.117203

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World Journal of Clinical Pediatrics

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2219-2808

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Pediatr. Dec 9, 2026; 15(4): 117203
Published online Dec 9, 2026. doi: 10.5409/wjcp.117203

Table 1 Characteristics of study participants, n (%)/median (interquartile range)

Parameters	All (n = 299)	Non-survivors (n = 105)	Survivors (n = 194)	P value
Gestational age (weeks), mean ± SD	33.3 ± 2.90	31.5 ± 3.09	34.3 ± 2.24	< 0.001^a
Birth weight (kg)	1.89 (1.40-2.40)	1.47 (1.00-2.00)	2.07 (1.67-2.60)	< 0.001^a
Male	173 (57.9)	54 (51.4)	119 (61.3)	0.098
Multiple gestation	82 (27.4)	28 (26.7)	54 (27.8)	0.829
Cesarean section	239 (79.9)	79 (75.2)	160 (82.5)	0.136
Gestational diabetes	19 (6.4)	4 (3.8)	15 (7.7)	0.222
Gestational hypertension	70 (23.4)	24 (22.9)	46 (23.7)	0.868
Premature rupture of membranes	48 (16.1)	21 (20.0)	27 (13.9)	0.171
Apgar score at 5 minutes	7 (6-8)	6 (4-6)	8 (7-8)	< 0.001^a
Resuscitation required	78 (26.1)	59 (56.2)	19 (9.8)	< 0.001^a
Non-invasive respiratory support	212 (70.9)	72 (68.6)	140 (72.2)	0.514
Invasive ventilation	107 (35.8)	97 (92.4)	10 (5.2)	< 0.001^a
Main system affection				0.074
Respiratory	250 (83.6)	90 (85.7)	160 (82.5)
Cardiac	11 (3.7)	3 (2.9)	8 (4.1)
Endocrine	11 (3.7)	1 (0.95)	10 (5.2)
Neurologic	12 (4.0)	9 (8.6)	3 (1.6)
Renal	5 (1.67)	0	5 (2.6)
Gastrointestinal	4 (1.3)	1 (0.95)	3 (1.6)
Hematologic	4 (1.3)	0	4 (2.1)
Others	2 (0.67)	1 (0.95)	1 (0.52)
CRIB II	4 (3-6)	6 (4-10)	3 (3-4)	< 0.001^a
SNAP-II	5 (0-12)	16 (5-24)	0 (0-5)	< 0.001^a
SNAPPE-II	5 (0-16)	17 (7-26)	1 (0-5)	< 0.001^a
STOPS	2 (2-4)	4 (3-7)	2 (2-2)	< 0.001^a
MSNS	11 (8-13)	7 (5-9)	12 (11-13)	< 0.001^a
nSOFA	2 (0-4)	6 (4-8)	0 (0-2)	< 0.001^a

^aP < 0.05.

CRIB II: Clinical Risk Index for Babies II; SNAP-II: Score for Neonatal Acute Physiology II; SNAPPE-II: Score for Neonatal Acute Physiology Perinatal Extension II; STOPS: Sensorium, temperature, oxygenation, perfusion, skin color, and blood sugar; MSNS: Modified Sick Neonatal Score; nSOFA: Neonatal Sequential Organ Failure Assessment.

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Table 2 Performance of scoring systems in predicting in-hospital neonatal mortality

Score	AUC (95% confidence interval)	Optimal cutoff	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Accuracy (%)
CRIB II	0.816 (0.764-0.867)	4	72.4	76.8	62.8	83.7	75.3
SNAP-II	0.875 (0.835-0.914)	5	87.6	72.7	63.4	91.6	77.9
SNAPPE-II	0.888 (0.848-0.927)	5	83	80.9	70.2	89.7	81.6
STOPS	0.885 (0.843-0.928)	2	81.9	90.2	81.9	90.2	87.3
MSNS	0.911 (0.874-0.949)	10	81.9	90.2	81.9	90.2	87.3
nSOFA	0.876 (0.831-0.921)	3	75.2	90.7	81.4	87.1	85.3

AUC: Area under the receiver operating characteristics curve; CRIB II: Clinical Risk Index for Babies II; SNAP-II: Score for Neonatal Acute Physiology II; SNAPPE-II: Score for Neonatal Acute Physiology Perinatal Extension II; STOPS: Sensorium, temperature, oxygenation, perfusion, skin color, and blood sugar; MSNS: Modified Sick Neonatal Score; nSOFA: Neonatal Sequential Organ Failure Assessment.

Full Size Table

Table 3 Comparison of area under the receiver operating characteristics curve measures among scoring systems for neonatal mortality prediction¹

Score	CRIB II	SNAP-II	SNAPPE-II	STOPS	MSNS	nSOFA
CRIB II	-	P = 0.033^a	P = 0.005^a	P = 0.020^a	P < 0.001^a	P = 0.046^a
SNAP-II		-	P = 0.113	P = 0.635	P = 0.066	P = 0.943
SNAPPE-II			-	P = 0.915	P =0.218	P = 0.575
STOPS				-	P = 0.095	P = 0.695
MSNS					-	P = 0.077
nSOFA						-

¹Using DeLong test.

^aP < 0.05.

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Citation: Mahmoud SM, Mohamed MM, Abdelfatah RZE, Abdelkreem E. Comparison of six neonatal mortality prediction scores: A prospective observational study. World J Clin Pediatr 2026; 15(4): 117203
URL: https://www.wjgnet.com/2219-2808/full/v15/i4/117203.htm
DOI: https://dx.doi.org/10.5409/wjcp.117203

Mahmoud SM, Mohamed MM, Abdelfatah RZE, Abdelkreem E. Comparison of six neonatal mortality prediction scores: A prospective observational study. World J Clin Pediatr 2026; 15(4): 117203 [DOI: 10.5409/wjcp.117203]

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