Determining the Predictive Value of CRIB-II and SNAPPE-II in the Mortality and Morbidity Rates of Premature Infants with a Gestational Age of Less Than 32 Weeks Hospitalized in the Neonatal Intensive Care Units of Al-Zahra S. and Shahid Beheshti Hospitals in Isfahan from 2021-2023

Document Type : Original Article(s)

Authors

1 Associate Professor, Department of Pediatrics, Division of Neonatology, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Metabolic Liver Disease Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study was conducted to determine the predictive value of CRIB-II, SNAPII, and SNAPPE-II in the mortality and morbidity rates of premature infants with a gestational age of less than 32 weeks hospitalized in the neonatal intensive care unit of Al-Zahra S. and Shahid Beheshti Hospitals in Isfahan from 2021-2023.
Methods: The present study is a cross-sectional analytical research that was carried out from 2021-2023 in the hospitals of Isfahan. A total of 206 infants with a gestational age of 24-32 weeks and a birth weight over 500 grams who met the inclusion criteria were included in the study. Demographic characteristics and complications of prematurity were recorded. Qualitative findings were calculated as numbers (percentages), and quantitative findings were presented as mean and standard deviation. A P of less than 0.05 was considered statistically significant.
Findings: The mean scores of SNAPPE-II, CRIBII, and SNAPII in infants with intraventricular hemorrhage (IVH) were significantly higher than those without IVH (P = 0.001). In infants with multiple seizures, only the mean SNAPII score was significantly higher than that of non-afflicted infants (P = 0.044). The predictive value of SNAPPE-II, CRIBII, and SNAPII for other complications was not significantly different (P > 0.05).
Conclusion: Our study showed that SNAPPE-II, CRIBII, and SNAPII indices have no predictive value for complications such as chronic lung disease, necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, and neonatal sepsis in premature infants with a gestational age of less than 32 weeks.

Highlights

Behzad Barekatain: Google Scholar, PubMed

Amirmohammad Armanian: Google Scholar, PubMed

Silva Housepian: Google Scholar, PubMed

Keywords

Main Subjects

References

  1. Zhu Z, Yuan L, Wang J, Li Q, Yang C, Gao X, et al. Mortality and morbidity of infants born extremely preterm at tertiary medical centers in China from 2010 to 2019. JAMA Netw Open 2021; 4(5):e219382.
  2. Lorenzo M, Laupacis M, Hopman WM, Ahmad I, Khurshid F. Morbidity in late preterm birth: a retrospective cohort study assessing the role of immaturity versus antecedent factors. Neonatology 2021; 118(3): 317-24.
  3. Menezes AM, Barros FC, Horta BL, Matijasevich A, Bertoldi AD, Oliveira PD, et al. Stillbirth, newborn and infant mortality: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982–2015. Int J Epidemiol 2019; 48(Suppl 1): i54–i62.
  4. Kliegman RM, Behrman RE, Jenson HB, Stanton BM. Nelson textbook of pediatrics. 8th ed. Amsterdam, Netherlands: Elsevier Health Sciences; 2019.
  5. Patrick SW, Schumacher RE, Davis MM. Methods of mortality risk adjustment in the NICU: a 20- year review. Pediatrics 2013; 131(Suppl 1): S68-74.
  6. Dalili H, Farrokhzad N, Kavyani Z, Sahebi L, Habibelahi A, Ashrafzadeh M, et al. Determination of predictive power of CRIB-II and SNAPPE-II in mortality risk of low gestational age or birth weight neonates admitted to NICU. Iran J Neonatol 2020; 11(4): 74-80.
  7. Ashrafzadeh M, Shirinabadi Farahani A, Rassouli M, Shariat M, Nasiri M, Faridpor F. The prediction of mortality risk in preterm infants hospitalized in the neonatal intensive care unit using SNAPPE-II score system. J Compr Ped 2019; 10(3): e85983.
  8. Babaei H, Jafrasteh A. The evaluation of CRIB II scoring system in predicting mortality in preterm newborns [in Persian]. Yafteh 2015; 16(4): 27-35.
  9. The International Neonatal Network. The CRIB (Clinical Risk Index for Babies) score: a tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units. Lancet 1993; 342(8865):193-8.
  10. Scoring systems for ICU and surgical patients: CRIB II (Clinical Risk Index for Babies). Available from: https://sfar.org/scores2/crib22.php.
  11. Richardson DK, Phibbs CS, Gray JE, et al. Birth weight and illness severity: independent predictors of neonatal mortality. Pediatrics 1993; 91(5): 969-75.
  12. Ressources et utilitaires. Scoring systems for ICU and surgical patients: SNAP-II and SNAPPE II (Score for Neonatal Acute Physiology and SNAP Perinatal Extension). Available from: https://sfar.org/scores2/snap22.php.
  13. Faridpour F, Shirinabadi Farahani A, Rassouli M, Shariat M, Nasiri M, Ashrafzadeh M. Clinical Risk Index for Babies (CRIB-II) Scoring System in Prediction of Mortality Risk in Preterm Neonates in the First 24 Hour. Evidence Based Care Journal 2020; 10 (2): 58-63.
  14. Karaarslan U, Bağ Ö, Arun Özer E, Helvaci M. Comparison of CrIb-II and Snap-Pe-II Scoring Systems in Predicting the Mortality and Morbidity of Very Low Birth Weight Infants. Turkish J Pediatr Dis 2017; 3: 183-7.
  15. Rachuri S, Paul S, Jaidev MD. SNAPPE II score: predictor of mortality in NICU. Int J Contemp Pediatr 2019; 6(2): 422-6.
  16. Mathew J, Bada Shekarappa C, Padubidri Nanyam Rao S. Correlation between Perfusion Index and CRIB Score in Sick Neonates Admitted to a Tertiary Center. J Trop Pediatr 2019, 65(1), 84-9.
  17. Khallaf MKT, El-Mahdy HS, Shihab NS, El-Shafiey RMG. Comparison between Score for Neonatal Acute Physiology-Perinatal Extension II (SNAP-PE II) and Clinical Risk Index for Babies (CRIB) in Prediction of Neonatal Mortality in Neonatal Intensive Care Unit (NICU) of Tanta University Hospital. Med J Cairo Univ 2018; 86(7): 3873-9.
  18. Ezz-Eldin ZM, Abdel Hamid TA, Youssef MRL, El-Din Nabil H. Clinical Risk Index for Babies (CRIB II) Scoring System in Prediction of Mortality in Premature Babies. J Clin Diagn Res 2015; 9(6): SC08-11.
  19. Lee SM, Lee MH, Chang YS. The clinical risk index for babies II for prediction of time-dependent mortality and short-term morbidities in very low birth weight infants. Neonatology 2019; 116(3): 244-51.

 

Journal of Isfahan Medical School
Volume 43, Issue 829
1st Week, November
November and December 2025
Pages 1058-1065

Files

History

  • Receive Date: 21 April 2025
  • Accept Date: 11 August 2025

Share

How to cite

Statistics