Development of a web-based tool –The Score Bebé ®– for enhancing neonatal risk stratification: A nationwide retrospective study

Background: In Ecuador, the neonatal mortality rate has increased from 4.1 to 6.0 per 1000 live births between 2014 and 2019. We aimed to develop and validate a health risk assessment tool for predicting neonatal mortality and to reach a nationwide consensus on stratified management. Methods: We retrospectively analyzed all neonatal deaths registered by the Ministry of Public Health between 2014 and 2017 in Ecuador. We developed a health risk assessment tool by using the information of deceased neonates between 2014 and 2016, and subsequently validated it using the information of deceased neonates in 2017. Several perinatal predictors were tested. The score was qualitatively refined by ~70 healthcare professionals in five Ecuadorian cities, and it was transformed into a web-based calculator with stratified suggestions of care. Results: Survival estimates differed significantly across the risk bands. The resulting Score Bebé® is available at https://scorebebe.com/ and includes stratified suggestions for care.