Department of Pediatrics, KLE University's JN Medical College, Belgaum, India.
J Perinatol. 2012 Jul;32(7):502-7. doi: 10.1038/jp.2011.134. Epub 2011 Sep 29.
To compare the pattern of thermal stabilization seen in infants born at a rural primary health center (PHC) with that of infants born in an modern urban tertiary care hospital (TCH).
Abdominal temperature (Ta) and foot temperature (Tf) of healthy term newborn infants were monitored and electronically recorded continuously from birth in the delivery room (DR) until 12 h of life in the postnatal ward (PNW) at two sites. A total of 71 infants were enrolled in the study: 51 infants at the PHC and 20 infants at the TCH.
In infants delivered at TCH the maximum mean (±s.d.) Ta of 36.4 ° C ± 0.48 was reached by 12 h, while at PHC maximum mean Ta was 35.4 °C (1.98) by 10.5 h. The mean Tf improved from the lowest value of 29.7 °C ± 1.3 at 4.5 h to 32.9 °C±1.6 by 12 h of life in infants delivered at TCH, whereas in infants delivered at PHC Tf remained low (maximum 30.7 °C) all through 12 h. The mean Td (Ta-Tf) gradually decreased from a maximum of 5.9 °C ± 1.6 at 4.5 h to 3.5 °C ± 1.5 by 12 h of life in infants born at TCH, but the Td remained at >5 °C even after 6 h of life in infants born at PHC, which was statistically significant (P<0.05). The calculated area between the Ta and Tf, a proxy for metabolic stress was greater in babies born at PHC than those born at TCH.
Our study shows that although both groups of newborn infants experienced significant thermal stress, infants delivered at PHC experienced significantly greater thermal stress than babies born at TCH. This difference could be attributed to the differences in thermal environment of DR and PNW between PHC and TCH.
比较在农村初级卫生保健中心（PHC）出生的婴儿与在现代化城市三级保健医院（TCH）出生的婴儿的热稳定模式。
在两个地点，对出生于产房（DR）的健康足月新生儿的腹部温度（Ta）和足部温度（Tf）进行连续监测和电子记录，直到出生后第 12 小时在产后病房（PNW）。共有 71 名婴儿参加了这项研究：51 名婴儿在 PHC，20 名婴儿在 TCH。
在 TCH 分娩的婴儿中，最大平均（±s.d.）Ta 在 12 小时达到 36.4°C±0.48，而在 PHC 最大平均 Ta 在 10.5 小时达到 35.4°C（1.98）。Tf 从 4.5 小时的最低值 29.7°C±1.3 逐渐升高至 12 小时的 32.9°C±1.6，而在 PHC 分娩的婴儿中，Tf 一直较低（最高 30.7°C）。在 TCH 分娩的婴儿中，Ta-Tf 的平均 Td（Ta-Tf）从 4.5 小时的最大值 5.9°C±1.6 逐渐下降至 12 小时的 3.5°C±1.5，但在 PHC 分娩的婴儿中，即使在出生后 6 小时，Td 仍保持在>5°C，差异具有统计学意义（P<0.05）。在 PHC 分娩的婴儿中，代表代谢应激的 Ta 和 Tf 之间的计算面积大于在 TCH 分娩的婴儿。
我们的研究表明，尽管两组新生儿都经历了显著的热应激，但在 PHC 分娩的婴儿经历了比 TCH 分娩的婴儿更大的热应激。这种差异可能归因于 PHC 和 TCH 之间 DR 和 PNW 的热环境差异。
