Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Department of Pediatrics, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan.
Sci Rep. 2022 Jul 13;12(1):11912. doi: 10.1038/s41598-022-15979-w.
The lower body temperature of preterm newborns at admission to neonatal intensive care units (NICUs) is inversely associated with their morbidities and mortalities before discharge. This retrospective cohort study aimed to determine whether admission rectal temperature in very low birth weight infants (VLBWIs) is independently associated with a composite outcome of death or moderate-to-severe neurodevelopmental impairments as defined by a performance developmental quotient of < 70 at three years of age. VLBWIs admitted to the NICU between April 2010 and March 2016 were assesed. Developmental assessment was completed in 216 newborns. Nine and two infants died before and after discharge, respectively. A higher admission temperature was associated with a lower incidence of death or moderate-to-severe neurodevelopmental impairments with adjustment for gestational age, sex, antenatal steroid use, Apgar score, severe intraventricular hemorrhage, and severe bronchopulmonary dysplasia (odds ratio [OR] 0.424; 95% confidence interval [CI] 0.250-0.717; p = 0.001). The admission temperature remained as an independent variable of adverse outcome at three years of age even when the study cohort was limited to surviving infants (OR 0.448; 95% CI 0.259-0.774; p = 0.004). Further studies are needed to assess whether avoiding low body temperature at admission results in better long-term neurodevelopmental outcomes in VLBWIs.
极低出生体重儿（VLBWIs）入院时的直肠温度与出院前的病死率和严重神经发育障碍发生率呈负相关。本回顾性队列研究旨在确定极低出生体重儿入院时的直肠温度是否与死亡或中重度神经发育障碍的复合结局（定义为 3 岁时发育商＜70）独立相关。评估了 2010 年 4 月至 2016 年 3 月期间入住新生儿重症监护病房（NICU）的 VLBWIs。对 216 名新生儿进行了发育评估。分别有 9 名和 2 名婴儿在出院前和出院后死亡。校正胎龄、性别、产前使用类固醇、阿普加评分、严重脑室出血和严重支气管肺发育不良后，入院时较高的体温与较低的病死率或中重度神经发育障碍发生率相关（比值比 [OR] 0.424；95%置信区间 [CI] 0.250-0.717；p=0.001）。即使将研究队列限制在存活婴儿中，入院体温仍然是 3 岁时不良结局的独立变量（OR 0.448；95%CI 0.259-0.774；p=0.004）。需要进一步研究以评估在 VLBWIs 中，入院时避免低体温是否能改善长期神经发育结局。
