Table 1

 MAIN score morbidity items with their scale values and goodness of fit parameters

Circle all items that apply between birth and discharge from the hospital or up to seven days of life, whichever is earlier. *⩾2 consecutive readings
ItemMorbidity attributeDiscrimatory index†χ2Scale
MAIN score, sum of the scale values of all checked items. †Discriminatory index, this is an indicator of discriminative capability of an item to capture various different grades of morbidity on the morbidity continuum. ‡χ2, this statistic reflects fitness of observed on predicted test score distributions. Scale, relative scale values derived from item response analyses that provide weighting to the item(s) reflecting its contribution to the overall morbidity score. NA, not available because of small number of subjects for χ2 analysis. All statistical parameters are derived fitting two parameter item analysis model using BILOG-W software. Please see text for further details.
Within 24 hours of birth
Cord blood pH
Resuscitation at birth
3Meconium below cords0.3512.7155
Apgar score (5 min)
4score 4–70.4713125
5score 1–30.970.8162
Apgar score (10 min)
7score 4–71.42154
8score 1–31.70.4183
Altered colour*
9Dusky/central cyanosis0.742.2145
Respiratory rate/min*
10<30 or >60 at 3–24 h0.545.3131
11>100 between 3–24 h0.5811.5140
Within seven days of birth
Heart rate/min*
12160–200 beat0.5410.3120
13>200 beat0.67NA183
14<100 beat0.53.1157
15Present at 1–120 h of age1.01.5129
16Present beyond 120 h of age1.369.2156
17Present at 1–120 h1.077.4154
18Apnea corrected by oxygen1.2610.8115
19Apnea corrected by resuscitation1.042.2140
Bleeding disorder
20Thrombocytopenia with or without bleeding disorder(GI/lungs/skin)0.840.5147
21Need for transfusion due to anemia or item 201.10.2170
Systolic BP (mean, mm of Hg)*
28–32 weeks32–42 weeks
Urine output*
23Low (<2 ml/kg/h)1.257.1141
24Tremors/single seizure0.814.5137
25Multiple seizures1.671.7155
26If >2 drugs used for seizures1.941.0183
Level of consciousness*
Oral feeding difficulties*
29Poor sucking within 24 h1.0410.281
30Poor sucking at 24 h–7 days1.328.098
31Poor sucking beyond 7 days1.0422.6119
32Persistent vomiting0.6213.9136
Respiratory status—assisted ventilation*
33Assisted ventilation beyond 24 h0.6630.8117
Respiratory status—mechanical ventilation*
34Mechanical ventilation within 24 h1.095.5130
35Mechanical ventilation at 24 h–7 days1.46.2135
36Mechanical ventilation beyond 7 days1.162.6162
Birth trauma
37Bone fracture—long bone/clavicle/skull0.7NA176
38Nerve injury (facial/peripheral)0.49NA183
39Subdural or intracerebral haematoma0.71NA179
Hypoglycaemia (lowest level)
40Blood glucose <2.2 mmol/l0.441.6151
Hyperbilirubinaemia, mmol/l (peak level)
41Serum bilirubin >250/phototherapy0.3728.9103
42Serum bilirubin >340/exchange transfusion0.42NA179
Bacterial culture
43Blood positive0.861.8162
44CSF positive0.930.1187
Intra-ventricular haemorrhage
45Grade 1 or 20.860.6152
46Grade 3 or 41.840.8186
Cardiopulmonary resuscitation
47Any time before discharge2.062.6162