Lee and Lee reported a simple clinical score for identifying a very low birth weight infant who may need extensive resuscitation at birth. This can help to identify a neonate who may require more aggressive management. The authors are from St. Vincent's Hospital and Catholic University of Korea.
Patient selection: very low birth weight infant (less than 1,500 g)
Parameters:
(1) gestational age in weeks
(2) antenatal steroid therapy
(3) amniotic fluid
Parameter
Finding
Points
gestational age
< 25 weeks
3
25 to 27 weeks
2
> 27 weeks
0
antenatal steroid therapy
none
1
incomplete
1
complete
0
amniotic fluid
normal
0
oligohydramnios
1
polyhydramnios
2
total score =
= SUM(points for all parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A score >= 2 has a sensitivity of 80% and specificity of 58%.
• A score >= 3 has a sensitivity of 64% and specificity of 74%.
• Both cut-offs have a similar Youden index and negative predictive value of 98%.
Performance:
• The area under the ROC curve is 0.74.
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