Comparing mortality risk models in VLBW and preterm infants: systematic review and meta-analysis

doi:10.1038/s41372-020-0650-0

Meta-Analysis

. 2020 May;40(5):695-703.

doi: 10.1038/s41372-020-0650-0. Epub 2020 Mar 18.

Comparing mortality risk models in VLBW and preterm infants: systematic review and meta-analysis

Jennifer S McLeod^#¹, Anitha Menon^#², Niki Matusko³, Gary M Weiner^{4

5}, Samir K Gadepalli^{1

4}, John Barks^{4

5}, George B Mychaliska^{1

4}, Erin E Perrone^{6

7}

Affiliations

¹ Department of Surgery, Section of Pediatric Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA.
² University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
³ Department of Surgery Statistics, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA.
⁴ University of Michigan, Michigan Medicine, Fetal Diagnosis and Treatment Center, Ann Arbor, MI, 48109, USA.
⁵ Department of Pediatrics, Neonatal-Perinatal Medicine Division, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA.
⁶ Department of Surgery, Section of Pediatric Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA. eperrone@med.umich.edu.
⁷ University of Michigan, Michigan Medicine, Fetal Diagnosis and Treatment Center, Ann Arbor, MI, 48109, USA. eperrone@med.umich.edu.

^# Contributed equally.

PMID: 32203174
DOI: 10.1038/s41372-020-0650-0

Meta-Analysis

Comparing mortality risk models in VLBW and preterm infants: systematic review and meta-analysis

Jennifer S McLeod et al. J Perinatol. 2020 May.

. 2020 May;40(5):695-703.

doi: 10.1038/s41372-020-0650-0. Epub 2020 Mar 18.

Authors

Jennifer S McLeod^#¹, Anitha Menon^#², Niki Matusko³, Gary M Weiner^{4

5}, Samir K Gadepalli^{1

4}, John Barks^{4

5}, George B Mychaliska^{1

4}, Erin E Perrone^{6

7}

Affiliations

¹ Department of Surgery, Section of Pediatric Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA.
² University of Michigan Medical School, Ann Arbor, MI, 48109, USA.
³ Department of Surgery Statistics, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA.
⁴ University of Michigan, Michigan Medicine, Fetal Diagnosis and Treatment Center, Ann Arbor, MI, 48109, USA.
⁵ Department of Pediatrics, Neonatal-Perinatal Medicine Division, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA.
⁶ Department of Surgery, Section of Pediatric Surgery, University of Michigan, Michigan Medicine, Ann Arbor, MI, 48109, USA. eperrone@med.umich.edu.
⁷ University of Michigan, Michigan Medicine, Fetal Diagnosis and Treatment Center, Ann Arbor, MI, 48109, USA. eperrone@med.umich.edu.

^# Contributed equally.

PMID: 32203174
DOI: 10.1038/s41372-020-0650-0

Abstract

Objective: To compare the prognostic accuracy of six neonatal illness severity scores (CRIB, CRIB II, SNAP, SNAP II, SNAP-PE, and SNAP-PE II), birthweight (BW), and gestational age (GA) for predicting pre-discharge mortality among very low birth weight (VLBW) infants (<1500 g) and very preterm infants (<32 weeks' gestational age).

Study design: PubMed, EMBASE, and Scopus were the data sources searched for studies published before January 2019. Data were extracted, pooled, and analyzed using random-effects models and reported as AUC with 95% confidence intervals (CI).

Results: Of 1659 screened studies, 24 met inclusion criteria. CRIB was the most discriminate for predicting pre-discharge mortality [AUC 0.88 (0.86-0.90)]. GA was the least discriminate [AUC 0.76 (0.72-0.80)].

Conclusions: Although the original CRIB score was the most accurate predictor of pre-discharge mortality, significant heterogeneity between studies lowers confidence in this pooled estimate. A more precise illness severity score to predict pre-discharge mortality is still needed.

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References

1. Althabe F, Bhutta Z, Blencowe H, Chandra-Mouli V, Chou D, Costello A, et al. Born Too Soon: The Global Action Report on Preterm Birth. World Health Organization, 2012. p. 1-112.
1. Beck S, Wojdyla D, Say L, Beltran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88:31–8. - PubMed
1. Patel RM, Rysavy MA, Bell EF, Tyson JE. Survival of infants born at periviable gestational ages. Clin Perinatol. 2017;44:287–303. - PubMed - PMC
1. Gilbert WM. The cost of preterm birth: the low cost versus high value of tocolysis. BJOG 2006;113(Suppl 3):4–9. - PubMed
1. MacDorman MF, Mathews TJ. The challenge of infant mortality: have we reached a plateau? Public health Rep. (Wash, DC: 1974). 2009;124:670–81.

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[1] Althabe F, Bhutta Z, Blencowe H, Chandra-Mouli V, Chou D, Costello A, et al. Born Too Soon: The Global Action Report on Preterm Birth. World Health Organization, 2012. p. 1-112.

[2] Althabe F, Bhutta Z, Blencowe H, Chandra-Mouli V, Chou D, Costello A, et al. Born Too Soon: The Global Action Report on Preterm Birth. World Health Organization, 2012. p. 1-112.

[3] Beck S, Wojdyla D, Say L, Beltran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88:31–8. - PubMed

[4] Beck S, Wojdyla D, Say L, Beltran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88:31–8. - PubMed

[5] Patel RM, Rysavy MA, Bell EF, Tyson JE. Survival of infants born at periviable gestational ages. Clin Perinatol. 2017;44:287–303. - PubMed - PMC

[6] Patel RM, Rysavy MA, Bell EF, Tyson JE. Survival of infants born at periviable gestational ages. Clin Perinatol. 2017;44:287–303. - PubMed - PMC

[7] Gilbert WM. The cost of preterm birth: the low cost versus high value of tocolysis. BJOG 2006;113(Suppl 3):4–9. - PubMed

[8] Gilbert WM. The cost of preterm birth: the low cost versus high value of tocolysis. BJOG 2006;113(Suppl 3):4–9. - PubMed

[9] MacDorman MF, Mathews TJ. The challenge of infant mortality: have we reached a plateau? Public health Rep. (Wash, DC: 1974). 2009;124:670–81.

[10] MacDorman MF, Mathews TJ. The challenge of infant mortality: have we reached a plateau? Public health Rep. (Wash, DC: 1974). 2009;124:670–81.

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Comparing mortality risk models in VLBW and preterm infants: systematic review and meta-analysis

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Comparing mortality risk models in VLBW and preterm infants: systematic review and meta-analysis

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