Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada.
J Perinatol. 2018 Jul;38(7):844-849. doi: 10.1038/s41372-018-0099-6. Epub 2018 May 24.
Preterm infants are at higher risk of developing hypothermia and complications from cold stress, resulting in high mortality and short-term morbidity. Our objective is to evaluate the association between admission temperatures of extremely low-gestational age neonates (ELGAN) (<29 weeks') and adverse short-term neurodevelopmental outcomes.
In this retrospective study, we included ELGAN admitted to NICUs across Canada between April 2009 and September 2011, who underwent neurodevelopmental assessment at 18-21 months' corrected age.
Of 2739 infants with a complete data set identified during the study period, 968 (35.3%) had admission temperatures ≤36.4 °C (hypothermia group), 1489 (54.5%) had temperature of 36.5-37.2 °C (normothermia group), and 282 (10.3%) had hyperthermia (≥37.3 °C). Their mean birth weight was 823 ± 230 g, 944 ± 227 g and 927 ± 223 g, respectively (p < 0.01). More than 50% of infants born at 23-24 weeks were in the hypothermic group compared to 28.5-36.1% at higher gestational ages. We found 39.5% of infants in the hypothermic group had primary composite outcome of death or severe neurodevelopmental impairment (sNDI). Multivariate logistic regression revealed an increased adjusted odd of primary composite outcome (OR = 1.32; 95% CI = [1.05, 1.66]) in the hypothermic group, compared to infants with normothermia on admission.
In our cohort of ELGAN, hypothermia on admission was associated with increased risk of death or sNDI.
早产儿面临体温过低和冷应激并发症的风险更高，导致死亡率高和短期发病率高。我们的目的是评估极低出生体重儿（ELGAN）（<29 周）入院时的体温与短期神经发育不良结局之间的关联。
在这项回顾性研究中，我们纳入了 2009 年 4 月至 2011 年 9 月期间在加拿大的新生儿重症监护病房（NICU）接受治疗，并在 18-21 个月校正年龄时接受神经发育评估的 ELGAN。
在研究期间确定的 2739 名具有完整数据集的婴儿中，有 968 名（35.3%）入院时的体温≤36.4°C（体温过低组），1489 名（54.5%）体温为 36.5-37.2°C（体温正常组），282 名（10.3%）体温升高（≥37.3°C）。他们的平均出生体重分别为 823±230g、944±227g 和 927±223g（p<0.01）。与较高胎龄的婴儿相比，23-24 周出生的婴儿中超过 50%处于体温过低组，而 28.5-36.1%处于体温正常组。我们发现体温过低组中有 39.5%的婴儿出现主要复合结局（死亡或严重神经发育障碍）。多变量逻辑回归显示，与入院时体温正常的婴儿相比，体温过低组的主要复合结局（死亡或严重神经发育障碍）的调整后的优势比（OR）增加（OR=1.32；95%CI=[1.05, 1.66]）。
在我们的 ELGAN 队列中，入院时体温过低与死亡或严重神经发育障碍的风险增加相关。
