Improved SNAPPE-II and CRIB II scores over a 15-year period

Objective: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).study design: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.results: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.conclusions: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.