title: SNAPPE-II application in newborns with very low birth weight: evaluation of adverse outcomes in severe placental dysfunction.
abstract: The aim of this study was to evaluate the ability of the admission Score for Neonatal Acute Physiology - Perinatal Extension-II (SNAPPE-II) to predict adverse outcome among premature very low birth weight (BW) infants with abnormal Doppler blood flow in the uterus secondary to severe placental insufficiency of early onset.
  
  
  
  A total of 86 neonates, weighing between 360 and 1498 g, were studied. Descriptive statistics of the population were reported. The areas under the receiver operating characteristics curves for the SNAPPE-II were calculated. The calibration of the model was assessed using the technique of Hosmer-Lemeshow. Adverse outcome was defined as mortality or the development of the following diagnoses: (1) periventricular-intraventricular hemorrhage (PIH); (2) retinopathy of prematurity stage 3 or 4; (3) periventricular leukomalacia; (4) bronchopulmonary dysplasia; (5) necrotizing enterocolitis (NEC).
  
  
  
  The SNAPPE-II area under curve was 0.86 (95% CI: 0.78-0.94) for mortality and 0.76 (95% CI: 0.65-0.86) for the prediction of adverse outcomes. Analyzing each morbidity variable, the SNAPPE-II AUC varied between 0.51 for NEC and 0.72 for PIH.
  
  
  
  SNAPPE-II shows accuracy in the prediction of adverse outcome for this highly selective group of very low BW infants compromised by severe placental insufficiency.
authors.affiliation: Clínica Perinatal Barra, Rio de Janeiro, RJ, Brazil. paulonassar@cpdt.com.br
authors.forename: Paulo Roberto Nassar
authors.initials: PR
authors.lastname: Carvalho
authors.forename: Maria Elizabeth Lopes
authors.initials: ME
authors.lastname: Moreira
authors.forename: Renato Augusto Moreira
authors.initials: RA
authors.lastname: Sá
authors.forename: Laudelino Marques
authors.initials: LM
authors.lastname: Lopes
mesh_terms: D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000175:diagnosis; D002543:Cerebral Hemorrhage / Q000175:diagnosis; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000503:physiopathology*; D019102:Infant, Very Low Birth Weight; D007969:Leukomalacia, Periventricular / Q000175:diagnosis; D010922:Placenta Diseases / Q000503:physiopathology*; D011247:Pregnancy; D012372:ROC Curve; D012178:Retinopathy of Prematurity / Q000175:diagnosis; D012720:Severity of Illness Index; D014599:Uterus / Q000098:blood supply