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
Item	Morbidity attribute		Discrimatory index†	χ²‡	Scale
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
1	⩽7.1		0.50	6.7	151
	Resuscitation at birth
2	Intubation		0.88	6.5	127
	Meconium
3	Meconium below cords		0.35	12.7	155
	Apgar score (5 min)
4	score 4–7		0.47	13	125
5	score 1–3		0.97	0.8	162
6	score<1		1.6	0.3	193
	Apgar score (10 min)
7	score 4–7		1.4	2	154
8	score 1–3		1.7	0.4	183
	Altered colour*
9	Dusky/central cyanosis		0.74	2.2	145
	Respiratory rate/min*
10	<30 or >60 at 3–24 h		0.54	5.3	131
11	>100 between 3–24 h		0.58	11.5	140
Within seven days of birth
	Heart rate/min*
12	160–200 beat		0.54	10.3	120
13	>200 beat		0.67	NA	183
14	<100 beat		0.5	3.1	157
	Hypotonia*
15	Present at 1–120 h of age		1.0	1.5	129
16	Present beyond 120 h of age		1.36	9.2	156
	Flaccidity*
17	Present at 1–120 h		1.07	7.4	154
	Apnea*
18	Apnea corrected by oxygen		1.26	10.8	115
19	Apnea corrected by resuscitation		1.04	2.2	140
	Bleeding disorder
20	Thrombocytopenia with or without bleeding disorder(GI/lungs/skin)		0.84	0.5	147
21	Need for transfusion due to anemia or item 20		1.1	0.2	170
	Systolic BP (mean, mm of Hg)*
	28–32 weeks	32–42 weeks
22	<30	<40	0.85	3.4	136
	Urine output*
23	Low (<2 ml/kg/h)		1.25	7.1	141
	Seizures
24	Tremors/single seizure		0.81	4.5	137
25	Multiple seizures		1.67	1.7	155
26	If >2 drugs used for seizures		1.94	1.0	183
	Level of consciousness*
27	Drowsy/lethargic		0.92	4.2	137
28	Stupor/obtundation/coma		1.75	0.6	187
	Oral feeding difficulties*
29	Poor sucking within 24 h		1.04	10.2	81
30	Poor sucking at 24 h–7 days		1.32	8.0	98
31	Poor sucking beyond 7 days		1.04	22.6	119
32	Persistent vomiting		0.62	13.9	136
	Respiratory status—assisted ventilation*
33	Assisted ventilation beyond 24 h		0.66	30.8	117
	Respiratory status—mechanical ventilation*
34	Mechanical ventilation within 24 h		1.09	5.5	130
35	Mechanical ventilation at 24 h–7 days		1.4	6.2	135
36	Mechanical ventilation beyond 7 days		1.16	2.6	162
	Birth trauma
37	Bone fracture—long bone/clavicle/skull		0.7	NA	176
38	Nerve injury (facial/peripheral)		0.49	NA	183
39	Subdural or intracerebral haematoma		0.71	NA	179
	Hypoglycaemia (lowest level)
40	Blood glucose <2.2 mmol/l		0.44	1.6	151
	Hyperbilirubinaemia, mmol/l (peak level)
41	Serum bilirubin >250/phototherapy		0.37	28.9	103
42	Serum bilirubin >340/exchange transfusion		0.42	NA	179
	Bacterial culture
43	Blood positive		0.86	1.8	162
44	CSF positive		0.93	0.1	187
	Intra-ventricular haemorrhage
45	Grade 1 or 2		0.86	0.6	152
46	Grade 3 or 4		1.84	0.8	186
	Cardiopulmonary resuscitation
47	Any time before discharge		2.06	2.6	162