Adaptation of the Score of Neonatal Acute Physiology-perinatal Extension II (SNAP-PE II) for Use in Resource-limited Settings

¹Department of Paediatrics, Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria

*Corresponding author: Irene Eseohe Akhigbe, MBBS, FWACP, Consultant Paediatrician and Neonatologist, Phone: +2348027121431, E-mail: [email protected]

Received Date: January 17, 2026

Publication Date: March 17, 2026

Citation: Akhigbe IE, et al. (2026). Adaptation of the Score of Neonatal Acute Physiology-perinatal Extension II (SNAP-PE II) for Use in Resource-limited Settings. Neonatal. 7(1):31.

Copyright: Akhigbe IE, et al. © (2026).

ABSTRACT

Background and Objectives: The widespread adoption of neonatal mortality risk assessment scores in triage of the ill newborn could greatly reduce the unacceptably high neonatal mortality in resource-limited countries especially those in sub-Saharan Africa. In spite of this potential, however, their use has not been established in the region due mainly to the invasive nature of some of the methods involved and the high cost of deployment of blood gas analyzers. We carried out this study to obviate these drawbacks by developing a simplified scoring system with minimally invasive methodologies. Method: We developed the Simplified Neonatal Acute Illness Severity Score (SNAISS) by adaptation of the Score of Neonatal Acute Physiology Perinatal Extension II (SNAP-PE II) through substitution of the arterial blood gas variables with hematocrit and peripheral oxygen saturation. We then evaluated the discriminant ability and calibration of SNAISS for adverse outcomes among 135 babies using receiver operator characteristic (ROC) curve and Hosmer-Lemeshow goodness of fit  test. We also assessed the relationship between outcome and SNAISS using Cramer’s V. Results: The area under ROC curve for the plot of outcome versus SNAISS was 0.926 and the Hosmer-Lemeshow goodness of fit  1.00 while the Cramer’s V for the relationship between SNAISS and neonatal outcome was 0.798. Conclusion: SNAISS has an excellent discrimination for adverse neonatal outcome, with a direct relationship between the scores and the risk of death. We recommend it as a readily available tool for use in clinical practice in resource-limited settings.

Keywords: Neonatal Mortality; Risk Assessment; Adapted Score of Neonatal Acute Physiology Perinatal Extension II; Simplified Neonatal Acute Illness Severity Score.

This is an early access version, the complete  HTML version will be available soon.