An expanded neonatal morbidity scale for premature infants.

We revised a neonatal morbidity scale (the NMS) that has served as a means for comparison of neonatal illness in studies of high-risk neonates after initial hospital discharge. With an inception cohort approach, 89 premature infants at an urban university hospital were studied with the expanded scale (the ENMS). The original scale, published in 1983, was reworked and expanded based on advances in the diagnosis and management of neonates. A social risk scale was added. Linear and logistic regression analyses were used to judge validity of the newly revised scale and to examine its predictive ability for outcomes at six months of age. Concurrent validity was supported by the relationship between the ENMS-SRS and: birthweight (R2 = .54), gestational age (R2 = .50), length of stay (R2 = .47). Inter-rater reliability was .95. The ENMS, embodying a contemporary patient profile, is valid for a population of premature infants in a U.S. urban setting and has predictive validity for a few outcomes within six months of discharge from a special care unit.