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  • Clinical Research Article
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A simple scoring system for prediction of IVH in very-low-birth-weight infants

Pediatric Research volume 94, pages 2033–2039 (2023)Cite this article

Abstract

Background

To develop a simple scoring system to predict either any or severe IVH in VLBW infants.

Methods

In this retrospective cohort study, 923 VLBW infants were randomly divided into derivation (n = 431) and validation (n = 492) cohorts. After stepwise multivariable logistic regression analyses, a risk score was assigned to independent predictors.

Results

The overall rates of any and severe IVH were 22.9% and 9.9%. Gestational age, maternal race, location of birth and sex were independent predictors of any IVH (AUC 0.75 in derivation cohort and 0.69 for validation cohort). Birth weight, Apgar score at 1 minute, location of birth and sex were independent predictors of severe IVH (AUC 0.84 in derivation cohort and 0.77 for validation cohort). For any IVH, infants in the high-risk category (total score 4 or 5) had > 50% likelihood of any IVH with a negative predictive value of 82.6%. For severe IVH, the total risk score ranged from 0–8, and infants in high-risk category (total score 6–8) had 30% likelihood of severe IVH with a negative predictive value of 94.9%.

Conclusion

We report an easy to calculate, validated scoring system with a high NPV to identify VLBW infants at highest risk of IVH.

Impact

  • We report a simple validated scoring system with a high NPV for prediction of IVH in VLBW infants.

  • The variables in the proposed model are available at birth and unlikely to be influenced by provider bias.

  • This scoring system can identify infants at risk of any and severe IVH, while most previous models predict only severe IVH.

  • This scoring system does not require access to web-based resources.

  • This scoring system can help in employing prevention strategies only for infants at highest risk of IVH and thus eliminate the risks of interventions in a large majority of VLBW infants.

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Fig. 1: Area under the curve
Fig. 2: Area under the curve

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

Authors thank Dr Preetha Prasad for sharing data from patients in her institution for this study.

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Authors and Affiliations

  1. Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, IL, USA

    Praveen Kumar

  2. School of Population Health, Toledo, OH, USA

    Mounika Polavarapu

Authors
  1. Praveen Kumar
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  2. Mounika Polavarapu
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Contributions

P.K. conceptualized and designed the study, drafted the initial manuscript, and critically reviewed and revised the manuscript. M.P. carried out the initial analyses, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Praveen Kumar.

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Kumar, P., Polavarapu, M. A simple scoring system for prediction of IVH in very-low-birth-weight infants. Pediatr Res 94, 2033–2039 (2023). https://doi.org/10.1038/s41390-023-02744-6

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