Updating a Perinatal Risk Scoring System to Predict Infant Mortality

Abstract

Objective The Birth Score Project (Project WATCH) began in the rural state of West Virginia (WV) in the United States in 1984. The project is intended to identify newborns with a greater risk of infant mortality. The primary objective of this study was to update the current Birth Score based on current literature and rigorous statistical methodology.

Study Design The study merged data from the Birth Score, Birth Certificate (birth years 2008–2013), and Infant Mortality Data (N = 121,640). The merged data were randomly divided into developmental (N = 85,148) and validation (N = 36,492) datasets. Risk scoring system was developed using the weighted multivariate risk score functions and consisted of infant and maternal factors.

Results The updated score ranged from 0 to 86. Infants with a score of ≥17 were categorized into the high score group (n = 15,387; 18.1%). The odds of infant mortality were 5.6 times higher (95% confidence interval: 4.4, 7.1) among those who had a high score versus low score.

Conclusion The updated score is a better predictor of infant mortality than the current Birth Score. This score has practical relevance for physicians in WV to identify newborns at the greatest risk of infant mortality and refer the infants to primary pediatric services and case management for close follow-up.

Keywords

infants - infant mortality - birth score - West Virginia

Authors' Contributions

A. U. conceptualized and designed the study, performed the initial analyses, and drafted the initial manuscript. C. L. conceptualized and designed the study, designed the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript. C. H. conceptualized and designed the study, drafted the historical significance of manuscript, and critically reviewed the manuscript. L. C., T. L., and T. H. conceptualized and designed the study and contributed to critical revision of the manuscript for important intellectual content. C. J. conceptualized and designed the study and drafted the introduction and the discussion sections of the manuscript. All authors read and approved the final version of the manuscript.

Note

The data supporting the current findings are not publicly available.

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