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Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia.

Chang HY, Sung YH, Wang SM, Lung HL, Chang JH, Hsu CH, Jim WT, Lee CH, Hung HF - PLoS ONE (2015)

Bottom Line: We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02) and smaller birth weight (1004 g vs. 1187 g, P < .001) compared to patients in the normothermia group.Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001), respiratory distress syndrome (RDS) (58.0% vs. 39.2%, P = .006), and mortality (18.5% vs. 5.1%, P = .005).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, MacKay Memorial Hospital, Hsinchu Branch, Hsinchu, Taiwan; Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.

ABSTRACT

Background: Neonatal hypothermia remains a common problem and is related to elevated morbidities and mortality. However, the long-term neurodevelopmental effects of admission hypothermia are still unknown. This study attempted to determine the short-term and long-term consequences of admission hypothermia in VLBW preterm infants.

Study design: This retrospective study measured the incidence and compared the outcomes of admission hypothermia in very low birth weight (VLBW) preterm infants in a tertiary-level neonatal intensive care unit. Infants were divided into the following groups: normothermia (36.5-37.5°C), mild hypothermia (36.0-36.4°C), moderate hypothermia (32.0-35.9°C), and severe hypothermia (< 32°C). We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.

Results: We studied 341 infants: 79 with normothermia, 100 with mild hypothermia, 162 with moderate hypothermia, and 0 with severe hypothermia. Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02) and smaller birth weight (1004 g vs. 1187 g, P < .001) compared to patients in the normothermia group. Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001), respiratory distress syndrome (RDS) (58.0% vs. 39.2%, P = .006), and mortality (18.5% vs. 5.1%, P = .005). Moderate hypothermia did not affect neurodevelopmental outcomes at 2 years' corrected age. Mild hypothermia had no effect on short-term or long-term outcomes.

Conclusions: Admission hypothermia was common in VLBW infants and correlated inversely with birth weight and gestational age. Although moderate hypothermia was associated with higher RDS and mortality rates, it may play a limited role among multifactorial causes of neurodevelopmental impairment.

No MeSH data available.


Related in: MedlinePlus

Temperature at admission to NICU (degrees centigrade).
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pone.0131976.g001: Temperature at admission to NICU (degrees centigrade).

Mentions: During the 4-year study period, 341 infants met all the inclusion criteria for the study. No severely hypothermic infants were identified. There were 79 infants (23.2%) in the normothermia group, 100 infants (29.3%) in the mild hypothermia group, and 162 infants (47.5%) in the moderate hypothermia group. The frequency distribution of admission temperatures is shown in Fig 1. Hypothermia (admission temperature < 36.5°C) was found in 76.8% of the study population. The mean admission temperature was 35.6 ± 0.5°C (range, 34.0–37.3°C). The admission temperature with the highest percentage of presentations was 36.0°C (Fig 1).


Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia.

Chang HY, Sung YH, Wang SM, Lung HL, Chang JH, Hsu CH, Jim WT, Lee CH, Hung HF - PLoS ONE (2015)

Temperature at admission to NICU (degrees centigrade).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4507863&req=5

pone.0131976.g001: Temperature at admission to NICU (degrees centigrade).
Mentions: During the 4-year study period, 341 infants met all the inclusion criteria for the study. No severely hypothermic infants were identified. There were 79 infants (23.2%) in the normothermia group, 100 infants (29.3%) in the mild hypothermia group, and 162 infants (47.5%) in the moderate hypothermia group. The frequency distribution of admission temperatures is shown in Fig 1. Hypothermia (admission temperature < 36.5°C) was found in 76.8% of the study population. The mean admission temperature was 35.6 ± 0.5°C (range, 34.0–37.3°C). The admission temperature with the highest percentage of presentations was 36.0°C (Fig 1).

Bottom Line: We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02) and smaller birth weight (1004 g vs. 1187 g, P < .001) compared to patients in the normothermia group.Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001), respiratory distress syndrome (RDS) (58.0% vs. 39.2%, P = .006), and mortality (18.5% vs. 5.1%, P = .005).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, MacKay Memorial Hospital, Hsinchu Branch, Hsinchu, Taiwan; Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.

ABSTRACT

Background: Neonatal hypothermia remains a common problem and is related to elevated morbidities and mortality. However, the long-term neurodevelopmental effects of admission hypothermia are still unknown. This study attempted to determine the short-term and long-term consequences of admission hypothermia in VLBW preterm infants.

Study design: This retrospective study measured the incidence and compared the outcomes of admission hypothermia in very low birth weight (VLBW) preterm infants in a tertiary-level neonatal intensive care unit. Infants were divided into the following groups: normothermia (36.5-37.5°C), mild hypothermia (36.0-36.4°C), moderate hypothermia (32.0-35.9°C), and severe hypothermia (< 32°C). We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.

Results: We studied 341 infants: 79 with normothermia, 100 with mild hypothermia, 162 with moderate hypothermia, and 0 with severe hypothermia. Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02) and smaller birth weight (1004 g vs. 1187 g, P < .001) compared to patients in the normothermia group. Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001), respiratory distress syndrome (RDS) (58.0% vs. 39.2%, P = .006), and mortality (18.5% vs. 5.1%, P = .005). Moderate hypothermia did not affect neurodevelopmental outcomes at 2 years' corrected age. Mild hypothermia had no effect on short-term or long-term outcomes.

Conclusions: Admission hypothermia was common in VLBW infants and correlated inversely with birth weight and gestational age. Although moderate hypothermia was associated with higher RDS and mortality rates, it may play a limited role among multifactorial causes of neurodevelopmental impairment.

No MeSH data available.


Related in: MedlinePlus