Effectiveness Of The Modified SNAPPE-II Score In Predicting Morbidity And Mortality Among Low-Birth-Weight Infants: A Systematic Review

Abstract

Introduction
Low-birthweight (LBW) infants face significant health risks, with morbidity and mortality influenced by illness severity, perinatal factors, and NICU care protocols. The Modified Score for Neonatal Acute Physiology Perinatal Extension-II (SNAPPE-II) is widely used to predict neonatal outcomes, yet variability exists in its accuracy for morbidity assessment.
Objective
To assess the effectiveness of SNAPPE-II in predicting morbidity and mortality among LBW neonates, synthesizing evidence from prospective and retrospective studies to establish its clinical utility.
Methods
A systematic literature search was conducted in PubMed, Scopus, and Cochrane Library, adhering to PRISMA guidelines. Studies evaluating SNAPPE-II scores in NICU-admitted LBW infants were included. Screening was conducted in Rayyan software independently by two reviewers. Data extraction focused on study design, sample size, morbidity and mortality predictions, and SNAPPE-II scoring thresholds. Data was analysed narratively.
Results
Thirteen studies met inclusion criteria, showing high predictive accuracy for mortality (AUROC ≥0.91 in high-quality studies). However, morbidity prediction varied, with inconsistent associations between SNAPPE-II scores and neonatal complications. Studies lacked documentation on feeding modality, limiting insights into nutritional influences on SNAPPE-II outcomes.