title: Improved SNAPPE-II and CRIB II scores over a 15-year period.
abstract: During the last decades mortality and morbidity of preterm infants have declined in the Western world. We hypothesized that the decrease in mortality in preterm infants was associated with a decrease in illness severity scores (SNAPPE-II and CRIB II scores).
  
  
  
  Subjects were inborn infants born between January 1997 and December 1999 (period 1) and between January 2006 and December 2011 (period 2) with a gestational age of 26+0 through 28+6 weeks and without congenital malformations (n=394). SNAPPE-II, CRIB II scores, mortality, severe morbidity and survival without morbidity were recorded. Outcomes between the two periods were analyzed using multivariable analysis.
  
  
  
  SNAPPE-II, but not CRIB II, scores were significantly lower for all GAs in period 2 compared with period 1. The risk of mortality for identical SNAPPE-II scores and CRIB II scores did not differ between the two periods. The risk of morbidity for identical SNAPPE-II scores and CRIB II scores was significantly lower in period 2 versus period 1. Hence, the chance of survival without morbidity for identical SNAPPE-II scores and CRIB II scores increased significantly in period 2 versus period 1.
  
  
  
  SNAPPE-II, but not CRIB II, scores decreased over 15 years. The risk of mortality for identical SNAPPE-II and CRIB II scores did not change, but the risk of morbidity decreased and the chance of survival without morbidity increased for identical SNAPPE-II and CRIB II scores. These findings suggest substantial improvements in both obstetrical and neonatal care.
authors.affiliation: Department of Neonatology, Birth Center, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: Department of Neonatology, Birth Center, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: de Vos
authors.affiliation: Department of Neonatology, Birth Center, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: J B
authors.initials: JB
authors.lastname: Derks
authors.affiliation: Department of Neonatology, Birth Center, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: E J H
authors.initials: EJH
authors.lastname: Mulder
mesh_terms: D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D009017:Morbidity; D015999:Multivariate Analysis; D009426:Netherlands; D012720:Severity of Illness Index