极低出生体重儿低体温症：分布、危险因素和结局。
Hypothermia in very low birth weight infants: distribution, risk factors and outcomes.
机构信息
Department of Pediatrics, Division of Neonatal and Developmental Medicine, School of Medicine, 750 Welch Road, Palo Alto, CA 94304, USA.
出版信息
J Perinatol. 2011 Apr;31 Suppl 1:S49-56. doi: 10.1038/jp.2010.177.
OBJECTIVE
The objective of this study was to study the epidemiology of neonatal hypothermia in preterm infants using World Health Organization (WHO) temperature criteria.
STUDY DESIGN
A population-based cohort of 8782 very low birth weight (VLBW) infants born in California neonatal intensive care units in 2006 and 2007. Associations between admission hypothermia and maternal and neonatal characteristics and outcomes were determined using logistic regression.
RESULT
In all, 56.2% of infants were hypothermic. Low birth weight, cesarean delivery and a low Apgar score were associated with hypothermia. Spontaneous labor, prolonged rupture of membranes and antenatal steroid administration were associated with decreased risk of hypothermia. Moderate hypothermia was associated with higher risk of intraventricular hemorrhage (IVH). Moderate and severe hypothermic conditions were associated with risk of death.
CONCLUSION
Hypothermia by WHO criteria is prevalent in VLBW infants and is associated with IVH and mortality. Use of WHO criteria could guide the need for quality improvement projects targeted toward the most vulnerable infants.
目的
本研究旨在使用世界卫生组织（WHO）的体温标准研究早产儿新生儿低体温的流行病学。
研究设计
本研究是一项基于人群的队列研究，纳入了 2006 年至 2007 年在加利福尼亚新生儿重症监护病房出生的 8782 名极低出生体重（VLBW）婴儿。使用逻辑回归确定入院时低体温与产妇和新生儿特征及结局之间的关系。
结果
总体而言，56.2%的婴儿出现低体温。低出生体重、剖宫产分娩和低 Apgar 评分与低体温相关。自发性分娩、胎膜早破时间延长和产前使用类固醇与低体温风险降低相关。中度低体温与更高的脑室内出血（IVH）风险相关。中度和重度低体温与死亡风险相关。
结论
根据 WHO 标准，VLBW 婴儿普遍存在低体温，且与 IVH 和死亡率相关。使用 WHO 标准可以指导需要针对最脆弱婴儿的质量改进项目。
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