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Admission temperature and hospital outcomes in extremely preterm infants
Author(s) -
Tay Victoria YJ,
Bolisetty Srinivas,
Bajuk Barbara,
Lui Kei,
Smyth John
Publication year - 2019
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.14187
Subject(s) - medicine , retinopathy of prematurity , odds ratio , gestational age , neonatal intensive care unit , confidence interval , necrotizing enterocolitis , pediatrics , hypothermia , intensive care , incidence (geometry) , birth weight , intraventricular hemorrhage , pregnancy , anesthesia , intensive care medicine , genetics , physics , optics , biology
Aim To evaluate trends in admission temperature and its effect on mortality and short‐term morbidities in extremely preterm infants. Methods A regional cohort study of infants born at 23–28 weeks’ gestation and admitted to the 10 neonatal intensive care units in New South Wales and the Australian Capital Territory between 1994 and 2012. Hypothermia was defined as skin temperature <36°C on admission to the neonatal intensive care unit. The primary outcome was hospital mortality. Results In total, 6267 infants were included. Mean admission temperatures improved significantly from 35.6°C in 1994 to 36.4°C in 2012 ( R < 0.88). The incidence of hypothermia was 29.5 and 13.9% between 1994–2005 and 2006–2012, respectively. In comparison with normothermic infants, hypothermic infants had lower gestational age at birth (26 vs. 27 weeks) and lower birthweight (800 vs. 976 g). In‐hospital mortality was higher in hypothermic infants (28.5 vs. 12.9%; odds ratio (OR) 2.69, 95% confidence interval (CI) 2.37–3.06). Severe intraventricular haemorrhage (12.1 vs. 8.5%, OR 1.48, 95% CI 1.25–1.75), necrotising enterocolitis (NEC) (11.0 vs. 7.5%; OR 1.54, 95% CI 1.29–1.83) and severe retinopathy of prematurity (16.5 vs. 8.9%; OR 2.02, 95% CI 1.70–2.39) were significantly higher in hypothermic infants. Multivariate regression analysis showed hypothermia was an independent risk factor for increased mortality (AOR (adjusted odds ratio ) 1.50, 95% CI 1.29–1.74, P < 0.001) and NEC (AOR 1.28, 95% CI 1.05–1.55, P = 0.01). Conclusions Admission temperatures improved during the time period. Hypothermia at admission was associated with a significant increase in mortality and NEC.