Predicting neonatal mortality in preterm neonates 32 weeks of gestation or less by using the modified NEOMOD score

Abstract Background Preterm neonates have a significantly higher mortality rate compared to full-term neonates. The Modified NEOMOD Score (mNEOMOD) predicts neonatal mortality in preterm neonates with high sensitivity and specificity. Objective This study aimed to evaluate the efficacy of the mNEOMOD in predicting neonatal mortality among preterm neonates and identify associated variables associated with increased neonatal mortality. Methods This diagnostic test study included neonates with a gestational age of ≤ 32 weeks admitted to the NICU from 2018 to 2022 at Chiang Mai University Hospital. The mNEOMOD assessed dysfunction across eight organ systems based on the worst cumulative score during the first seven days of life. Predictive accuracy was determined using the Area Under the ROC Curve (AUC). Clinical and demographic variables were compared between survival and death groups. Results Among 280 neonates, 277 (98.9%) had multi-organ dysfunction (MOD), with a mortality rate of 10.7%. The mNEOMOD showed higher scores in the mortality group compared to the survival group (median score: 13 vs. 5). The predictive accuracy was highest at a cutoff value of 9, with 100% sensitivity and 91.2% specificity. Significant variables for increased mortality included severe intraventricular hemorrhage (aOR 8.76, p < 0.001) and APGAR score < 7 at 5 min (aOR 3.46, p 0.010). Conclusion The mNEOMOD is reliable tool for predicting neonatal mortality in preterm neonates ≤ 32 weeks gestation.