Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

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• 作者：Emilija Wilson ; RN ; RM¹ ; ² ; ³ ; ^{emilija.wilson@ki.se" class="auth_mail" title="E-mail the corresponding author} ; Rolf F. Maier ; MD ; PhD⁴ ; Mikael Norman ; MD ; PhD¹ ; ² ; Bjoern Misselwitz ; MD ; MPH⁵ ; Elizabeth A. Howell ; MD ; PhD⁶ ; ⁷ ; ⁸ ; Jennifer Zeitlin ; MA ; DSc⁹ ; ¹⁰ ; Anna-Karin Bonamy ; MD ; PhD¹¹ ; ¹² ; on behalf of the Effective Perinatal Intensive Care in Europe (EPICE) Research Group^&lowast ; ; Patrick Van Reempts ; MD ; PhD ; Evelyne Martens ; MSc ; Guy Martens ; Eng ; Ole Pryds ; MD ; PhD ; Klaus Boerch ; MD ; Asbjoern Hasselager ; MD ; Lene Huusom ; MD ; Tom Weber ; MD ; PhD ; Liis Toome ; MD ; PhD ; Heili Varendi ; MD ; PhD ; Patrick Truffert ; MD ; PhD ; Pierre-Henri Jarreau ; MD ; PhD ; Pierre-Yves Ancel ; PhD ; Beatrice Blondel ; PhD ; Antoine Burguet ; MD ; PhD ; Stephan Schmidt ; MD ; PhD ; Ludwig Gortner ; MD ; PhD ; Marina Cuttini ; MD ; PhD ; Ileana Croci ; Dante Baronciani ; MD ; Giancarlo Gargano ; MD ; Virgilio Carnielli ; MD ; PhD ; Domenico Di Lallo ; MD ; Rocco Agostino ; MD ; PhD ; Francesco Franco ; MSc ; Corine Koopman-Esseboom ; MD ; PhD ; Joppe Nijman ; MD ; PhD ; Arno van Heijst ; MD ; PhD ; Janusz Gadzinowski ; MD ; PhD ; Jan Mazela ; MD ; PhD ; Luis M. Gra&ccedil ; a ; MD ; PhD ; Maria Ceu Machado ; MD ; PhD ; Rui Carapato ; MD ; Henrique Barros ; MD ; PhD ; Carina Rodrigues ; MSc ; Teresa Rodrigues ; MD ; PhD ; Elizabeth Draper ; BSc (hons) MPhil ; PhD ; Elaine M. Boyle ; MBChB ; MD ; PhD ; Brad Manktelow ; BSc ; MSc ; PhD ; David W.A. Milligan ; MD ; Alan Fenton ; MD
• 关键词：very preterm birth ; neonatal intensive care ; epidemiology
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：175
• 期：Complete
• 页码：61-67.e4
• 全文大小：489 K

文摘

To investigate the association between body temperature at admission to neonatal intensive care and in-hospital mortality in very preterm infants, stratified by postnatal age of death. Moreover, we assessed the association between admission temperature and neonatal morbidity.

d="absSec_2">Study design

d="abspara0015">In this cohort study from 19 regions in 11 European countries, we measured body temperature at admission for infants admitted for neonatal care after very preterm birth (<32 weeks of gestation; n = 5697) who were followed to discharge or death. Associations between body temperature at admission and in-hospital mortality and neonatal morbidity were analyzed by the use of mixed effects generalized linear models. The final model adjusted for pregnancy complications, singleton or multiple pregnancy, antenatal corticosteroids, mode of delivery, gestational age, infant size and sex, and Apgar score <7 at 5 minutes.

d="absSec_3">Results

d="abspara0020">A total of 53.4% of the cohort had a body temperature at admission less than 36.5&deg;C, and 12.9% below 35.5&deg;C. In the adjusted model, an admission temperature <35.5&deg;C was associated with increased mortality at postnatal ages 1-6 days, (risk ratio 2.41; 95% CI 1.45-4.00), and 7-28 days (risk ratio 1.79; 1.15-2.78) but not after 28 days of age. We found no associations between admission temperature and neonatal morbidity.

d="absSec_4">Conclusion

d="abspara0025">Admission hypothermia after very preterm birth is a significant problem in Europe, associated with an increased risk of early and late neonatal death.