Admission temperature and hospital outcomes in extremely preterm infants

Tay, Victoria YJ; Bolisetty, Srinivas; Bajuk, Barbara; Lui, Kei; Smyth, John

doi:10.1111/jpc.14187

Cited by 16 publications

(25 citation statements)

References 32 publications

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“…Sindhu et al [21] reported that a reduction in an infants' body temperature is the primary cause of 18-42% of annual infant mortality worldwide. A recent study by Tay et al [22] reported that hypothermia at NICU admission in VLBW newborns was independently associated with mortality. Mortality was inversely related to admission temperature, although the relationship was not linear but rather a quadratic curve.…”

Section: Discussionmentioning

confidence: 99%

Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

Wang

et al. 2020

Preprint

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Abstract Background The objective of this study was to evaluate the association between admission hypothermia and neonatal outcomes in very low-birth weight (VLBW) infants in multiple neonatal intensive care units (NICUs) in China. Methods Since January 1, 2018, a neonatal homogeneous cooperative research platform has been established. The platform collects clinical data in a prospective manner on preterm infants with birth weights (BWs)<1500 g and gestational ages (GAs)<34 weeks born in 28 NICUs in Shandong Province. These infants were divided into normothermia, mild or moderate/severe hypothermia groups according to the World Health Organization (WHO) classifications of hypothermia. Associations between outcomes and hypothermia were tested in a bivariate analysis, followed by a stepwise logistic regression analysis. Results A total of 1247 VLBW infants were included in this analysis, of which 1100 infants (88.2%) were included in the hypothermia group, 554 infants (44.4%) in the mild hypothermia group and 546 infants (43.8%) in the moderate/severe hypothermia group. Small for gestational age (SGA), caesarean section, a low Apgar score at 5 min and intubation in the delivery room (DR) were related to admission hypothermia (AH). Mortality was the lowest when their admission temperature was 36.5~37.5°C, and after adjustment for maternal and infant characteristics, mortality was significantly associated with AH. Compared with infants with normothermia (36.5~37.5°C), the adjusted ORs of all deaths increased to 4.148 (95% CI 1.505-11.437) and 1.806 (95% CI 0.651-5.009) for infants with moderate/severe hypothermia and mild hypothermia, respectively. AH was also associated with a high likelihood of respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), and late-onset neonatal sepsis (LOS). Conclusions AH is still very high in VLBW infants in NICUs in China. SGA, caesarean section, antenatal steroid use, a low Apgar score at 5 min and intubation in the DR were associated with increased odds of hypothermia. Moderate/severe hypothermia was associated with mortality and poor outcomes, such as RDS, IVH, LOS, etc.

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Section: Discussionmentioning

confidence: 99%

Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Sindhu et al [22] reported that a reduction in an infants' body temperature is the primary cause of 18-42% of annual infant mortality worldwide. A recent study by Tay et al [23] reported that hypothermia at NICU admission in extremely preterm infants was independently associated with mortality. Our study showed that mortality was inversely related to admission temperature, although the relationship was not linear but rather a quadratic curve.…”

Section: Discussionmentioning

confidence: 99%

Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

Wang

Huang

et al. 2020

BMC Pediatr

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Background: The objective of this prospective, multicentre, observational cohort study was to evaluate the association between admission hypothermia and neonatal outcomes in very low-birth weight (VLBW) infants in multiple neonatal intensive care units (NICUs) in China. Methods: Since January 1, 2018, a neonatal homogeneous cooperative research platform-Shandong Neonatal Network (SNN) has been established. The platform collects clinical data in a prospective manner on preterm infants with birth weights (BWs) < 1500 g and gestational ages (GAs) < 34 weeks born in 28 NICUs in Shandong Province. These infants were divided into normothermia, mild or moderate/severe hypothermia groups according to the World Health Organization (WHO) classifications of hypothermia. Associations between outcomes and hypothermia were tested in a bivariate analysis, followed by a logistic regression analysis.

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“…To reduce this effect, the infants did not receive delivery room resuscitation. ose admitted to the NICU after 2 h of delivery were excluded from the analysis because of the impact of hypothermia on neonatal morbidity and mortality [28][29][30]. ird, the infants not exposed to ACS were not included in this study, although we believed that excluding infants unexposed to ACS might not affect the rates of neonatal mortality and/or respiratory outcomes with the administration-to-birth interval of 2-7 d as a reference.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The Relationship between Antenatal Corticosteroid Administration-to-Delivery Intervals and Neonatal Respiratory Distress Syndrome and Respiratory Support

Jiang

et al. 2022

Journal of Healthcare Engineering

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Background. Administration of antenatal corticosteroids (ACSs) is an effective strategy for managing preterm infants, which improves neonatal respiratory distress syndrome (NRDS) and attenuates the risk of neonatal mortality. However, many preterm infants are not exposed to a complete course of ACS administration, and the effects of different ACS-to-delivery intervals on NRDS and respiratory support remain unclear. Therefore, this study explored the relationship between ACS-to-birth intervals and NRDS and respiratory support in preterm infants. Methods. In this retrospective cohort study, the preterm infants born between 240/7 and 316/7 wks of gestation were recruited from January 2015 to July 2021. All participants were categorised based on the time interval from the first ACS dose to delivery: <24 h, 1-2 d, 2–7 d, and >7 d. Multivariable logistic regression analysis examined the relationships between the ACS-to-birth interval and primary or secondary outcome while adjusting for potential confounders. Results. Of the 706 eligible neonates, 264, 83, 292, and 67 received ACS-to-delivery intervals of <24 h, 1-2 d, 2–7 d, and >7 d, respectively. After adjusting these confounding factors, the multivariable logistic analysis showed a significantly increased risk of NRDS (aOR: 1.8, 95% CI: 1.2–2.7), neonatal mortality (aOR: 2.8, 95% CI: 1.1–6.8), the need for surfactant use (aOR: 2.7, 95% CI: 1.7–4.4), endotracheal intubation in the delivery room (aOR: 1.9, 95% CI: 1.0–3.7), and mechanical ventilation (aOR: 1.9, 95% CI: 1.1–3.4) in the ACS-to-delivery interval of <24 h group when compared with the ACS-to-birth interval of 2–7 d group. Conclusions. Neonatal outcomes such as NRDS, neonatal mortality, the need for surfactant use, intubation in the delivery room, and the risk of mechanical ventilation are higher when the neonates are exposed to an ACS interval for less than 24 h before delivery.

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Admission temperature and hospital outcomes in extremely preterm infants

Abstract: Admission temperatures improved during the time period. Hypothermia at admission was associated with a significant increase in mortality and NEC.

Cited by 16 publications

References 32 publications

Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

The Relationship between Antenatal Corticosteroid Administration-to-Delivery Intervals and Neonatal Respiratory Distress Syndrome and Respiratory Support

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