The Morbidity Assessment Index for
Newborns (MAIN) can be used to evaluate newborn infants for morbidity. The tool
is intended to allow comparison of the impact from obstetrical therapeutic
strategies on neonatal outcomes.
|
Item
|
Description
|
Value
|
|
1
|
poor sucking within 24 hours
|
81
|
|
2
|
poor sucking at 24 hours to 7 days
|
98
|
|
3
|
serum bilirubin 251-340 µmol/L, OR
need for phototherapy
|
103
|
|
4
|
apnea and need for oxygen
|
115
|
|
5
|
assisted ventilation beyond 24 hours
|
117
|
|
6
|
poor sucking beyond 7 days
|
119
|
|
7
|
heart rate > 160 beats per minute
|
120
|
|
8
|
Apgar score at 05 minutes < 7
|
125
|
|
9
|
resuscitation at birth with
intubation
|
127
|
|
10
|
hypotonia at 1-120 hours
|
129
|
|
11
|
mechanical ventilation within 24
hours
|
130
|
|
12
|
respiratory rate < 30 per minute
or > 60 per minute at 3-24 hours
|
131
|
|
13
|
mechanical ventilation at 24 hours
to 7 days
|
135
|
|
14
|
low systolic blood pressure (< 30
mm Hg for 28-32 weeks, < 40 mm Hg for 32-42 weeks)
|
136
|
|
15
|
persistent vomiting
|
136
|
|
16
|
level of consciousness: drowsy or
lethargic
|
137
|
|
17
|
single seizure, OR tremors
|
137
|
|
18
|
apnea corrected by resuscitation
|
140
|
|
19
|
respiratory rate > 100 per minute
3 to 24 hours
|
140
|
|
20
|
low urine output (< 2 mL per kg
per hour)
|
141
|
|
21
|
altered color: central cyanosis or
dusky
|
145
|
|
22
|
bleeding skin, lungs or GI tract
|
147
|
|
22
|
thrombocytopenia
|
147
|
|
23
|
cord blood pH < 7.1
|
151
|
|
24
|
hypoglycemia (< 2.2 mmol/L)
|
151
|
|
25
|
intraventricular hemorrhage: Grade 1
or 2
|
152
|
|
26
|
Apgar score at 10 minutes < 7
|
154
|
|
27
|
flaccidity at 1-120 hours
|
154
|
|
28
|
meconium below cords
|
155
|
|
29
|
multiple seizures
|
155
|
|
30
|
hypotonia persisting beyond 120
hours
|
156
|
|
31
|
heart rate < 100 beats per minute
|
157
|
|
32
|
mechanical ventilation beyond 7 days
|
161
|
|
33
|
cardiopulmonary resuscitation at any
time
|
162
|
|
34
|
bacterial culture of blood: positive
findings
|
162
|
|
35
|
Apgar score at 05 minutes < 4
|
162
|
|
36
|
transfusion for anemia or low
platelet count
|
170
|
|
37
|
fracture of long bone, clavicle or
skull
|
176
|
|
38
|
serum bilirubin > 340 µmol/L, OR
need for exchange transfusion
|
179
|
|
39
|
subdural or intracranial hematoma
|
179
|
|
40
|
facial or peripheral nerve injury at
birth
|
183
|
|
41
|
heart rate > 200 beats per minute
|
183
|
|
42
|
intraventricular hemorrhage: Grade 3
or 4
|
186
|
|
43
|
bacterial culture of CSF: positive
findings
|
187
|
|
44
|
Apgar score at 10 minutes < 4
|
187
|
|
45
|
multiple seizures and > 2 drugs
needed to treat
|
183
|
|
46
|
level of consciousness: stupor,
obtundation, coma
|
187
|
|
47
|
Apgar score at 05 minutes < 1
|
193
|
|
Group
|
Description
|
Value
|
Item
|
|
Apgar
|
Apgar score at 05 minutes < 1
|
193
|
47
|
|
Apgar
|
Apgar score at 05 minutes < 4
|
162
|
35
|
|
Apgar
|
Apgar score at 05 minutes < 7
|
125
|
8
|
|
Apgar
|
Apgar score at 10 minutes < 4
|
187
|
44
|
|
Apgar
|
Apgar score at 10 minutes < 7
|
154
|
26
|
|
bilirubin
|
serum bilirubin 251-340 µmol/L, OR
need for phototherapy
|
103
|
3
|
|
bilirubin
|
serum bilirubin > 340 µmol/L , OR
need for exchange transfusion
|
179
|
38
|
|
blood
|
bleeding skin, lungs or GI tract, OR
thrombocytopenia
|
147
|
22
|
|
blood
|
transfusion for anemia or low
platelet count
|
170
|
36
|
|
CNS
|
intraventricular hemorrhage: Grade 1
or 2
|
152
|
25
|
|
CNS
|
intraventricular hemorrhage: Grade 3
or 4
|
186
|
42
|
|
CNS
|
subdural or intracranial hematoma
|
179
|
39
|
|
CNS
|
level of consciousness: drowsy or
lethargic
|
137
|
16
|
|
CNS
|
level of consciousness: stupor,
obtundation, coma
|
187
|
46
|
|
culture
|
bacterial culture of CSF: positive
findings
|
187
|
43
|
|
culture
|
bacterial cutlure of blood: positive
findings
|
162
|
34
|
|
general
|
altered color: central cyanosis or
dusky
|
145
|
21
|
|
general
|
cord blood pH < 7.1
|
151
|
23
|
|
general
|
facial or peripheral nerve injury at
birth
|
183
|
40
|
|
general
|
fracture of long bone, clavicle or
skull
|
176
|
37
|
|
general
|
hypoglycemia (< 2.2 mmol/L)
|
151
|
24
|
|
general
|
low systolic blood pressure (< 30
mm Hg for 28-32 weeks, < 40 mm Hg for 32-42 weeks)
|
136
|
14
|
|
general
|
low urine output (< 2 mL per kg
per hour)
|
141
|
20
|
|
general
|
persistent vomiting
|
136
|
15
|
|
lung
|
apnea and need for oxygen
|
115
|