Paediatric intensive care unit, Amiens university hospital, 80054 Amiens, France; PériTox Laboratory UMR_I 01, UFR de médecine, University of Picardie-Jules-Verne, 80054 Amiens, France.
INSERM U-1105, Paediatric neurology unit, Amiens university hospital, Amiens, France.
Arch Pediatr. 2021 Apr;28(3):197-203. doi: 10.1016/j.arcped.2021.02.005. Epub 2021 Mar 6.
Hypothermia is associated with elevated mortality in the preterm infant. The preterm infant's thermoregulatory capacity is limited, and the thermal environment in an incubator is often perturbed by nursing procedures. We evaluated the incidence of a postnatal low body temperature and hypothermia in preterm infants and its association with mortality.
We measured the lowest body temperature during the first 24h of life (T ) and hypothermia (T <36.0°C) in preterm infants (gestational age: 23-31 weeks) in a neonatal intensive care unit. Prenatal and neonatal characteristics associated with mortality were identified in univariate and multivariable analyses.
A total of 102 preterm infants were included, with a mean gestational age at birth of 28.4±2.3 weeks. The incidence of hypothermia during the first 24h was 53%. A Cox multivariate regression model indicated that T (hazard ratio (HR) [95% confidence interval]: 0.57 [0.36-0.90]; P=0.017), gestational age (0.62 [0.50-0.76]; P<0.001), and amine use (4.55 [2.01-10.28]; P=0.001) were significantly associated with mortality. When considering a threshold for T , a value of 35.0°C had the highest HR (3.30 [1.42-7.68]; P<0.01).
In preterm infants, the incidence of hypothermia during the first 24h of life was 53%. T had an influence on mortality, independently of other factors (notably birth weight and amine use). Within the framework of a quality improvement strategy, the implementation of a thermoregulation bundle is required to prevent hypothermia and decrease mortality in preterm infants.
体温过低与早产儿死亡率升高有关。早产儿的体温调节能力有限，而保温箱中的热环境常常受到护理操作的干扰。我们评估了早产儿出生后体温过低和体温过低的发生率及其与死亡率的关系。
我们测量了新生儿重症监护病房（NICU）中 23-31 周早产儿出生后 24 小时内的最低体温（T）和体温过低（T<36.0°C）。在单变量和多变量分析中，确定与死亡率相关的产前和新生儿特征。
共纳入 102 例早产儿，平均胎龄为 28.4±2.3 周。出生后 24 小时内体温过低的发生率为 53%。Cox 多变量回归模型表明，T（风险比（HR）[95%置信区间]：0.57 [0.36-0.90]；P=0.017）、胎龄（0.62 [0.50-0.76]；P<0.001）和使用胺类药物（4.55 [2.01-10.28]；P=0.001）与死亡率显著相关。当考虑 T 的阈值时，35.0°C 的值具有最高的 HR（3.30 [1.42-7.68]；P<0.01）。
在早产儿中，出生后 24 小时内体温过低的发生率为 53%。T 对死亡率有影响，独立于其他因素（特别是出生体重和使用胺类药物）。在质量改进策略的框架内，需要实施体温调节套件，以防止早产儿体温过低和死亡率升高。
