Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

• Main Authors: Yong-hui Yu (Author), Li Wang (Author), Lei Huang (Author), Li-ling Wang (Author), Xiao-yang Huang (Author), Xiu-fang Fan (Author), Yan-jie Ding (Author), Cheng-yuan Zhang (Author), Qiang Liu (Author), Ai-rong Sun (Author), Yue-hua Zhao (Author), Guo Yao (Author), Cong Li (Author), Xiu-xiang Liu (Author), Jing-cai Wu (Author), Zhen-ying Yang (Author), Tong Chen (Author), Xue-yun Ren (Author), Jing Li (Author), Mei-rong Bi (Author), Fu-dong Peng (Author), Min Geng (Author), Bing-ping Qiu (Author), Ri-ming Zhao (Author), Shi-ping Niu (Author), Ren-xia Zhu (Author), Yao Chen (Author), Yan-ling Gao (Author), Li-ping Deng (Author)
• Format: Book
• Published: BMC, 2020-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Abstract Background The objective of this prospective, multicentre, observational cohort study was to evaluate the association between admission hypothermia and neonatal outcomes in very low-birth weight (VLBW) infants in multiple neonatal intensive care units (NICUs) in China. Methods Since January 1, 2018, a neonatal homogeneous cooperative research platform-Shandong Neonatal Network (SNN) has been established. The platform collects clinical data in a prospective manner on preterm infants with birth weights (BWs) < 1500 g and gestational ages (GAs) < 34 weeks born in 28 NICUs in Shandong Province. These infants were divided into normothermia, mild or moderate/severe hypothermia groups according to the World Health Organization (WHO) classifications of hypothermia. Associations between outcomes and hypothermia were tested in a bivariate analysis, followed by a logistic regression analysis. Results A total of 1247 VLBW infants were included in this analysis, of which 1100 infants (88.2%) were included in the hypothermia group, 554 infants (44.4%) in the mild hypothermia group and 546 infants (43.8%) in the moderate/severe hypothermia group. Small for gestational age (SGA), caesarean section, a low Apgar score at 5 min and intubation in the delivery room (DR) were related to admission hypothermia (AH). Mortality was the lowest when their admission temperature was 36.5 ~ 37.5 °C, and after adjustment for maternal and infant characteristics, mortality was significantly associated with AH. Compared with infants with normothermia (36.5 ~ 37.5 °C), the adjusted ORs of all deaths increased to 4.148 (95% CI 1.505-11.437) and 1.806 (95% CI 0.651-5.009) for infants with moderate/severe hypothermia and mild hypothermia, respectively. AH was also associated with a high likelihood of respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), and late-onset neonatal sepsis (LOS). Conclusions AH is still very high in VLBW infants in NICUs in China. SGA, caesarean section, a low Apgar score at 5 min and intubation in the DR were associated with increased odds of hypothermia. Moderate/severe hypothermia was associated with mortality and poor outcomes, such as RDS, IVH, LOS.

Item Description

10.1186/s12887-020-02221-7
1471-2431