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Association of admission temperature and death or adverse neurodevelopmental outcomes in extremely low-gestational age neonates

Journal of Perinatology volume 38, pages 844–849 (2018)Cite this article

Subjects

Abstract

Objective

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.

Study design

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.

Results

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.

Conclusions

In our cohort of ELGAN, hypothermia on admission was associated with increased risk of death or sNDI.

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Acknowledgements

We gratefully acknowledge all site investigators and data abstractors of the Canadian Neonatal Network. We also extend our thanks to staff at the Maternal-Infant Care Research Centre at Mount Sinai Hospital, Toronto, ON, for providing organizational, statistical and editorial support for this project. Specifically, we extend our thanks to Junmin Yang, for statistical support.

Funding

Organizational support was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, ON, Canada. MiCare is supported by a team grant from the Canadian Institutes of Health Research (CIHR, FRN87518) and in-kind support from Mount Sinai Hospital. Dr Shah holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding agencies had no role in the design and conduct of the study; collection, analysis and interpretation of the data; the writing of the report; and the decision to submit the manuscript for publication. This work was supported by the Canadian Neonatal Network (CNN) Coordinating Centre, which is based at the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. The CNN and MiCare are supported by team grant funding from the Canadian Institutes of Health Research (FRN87518, PBN150642). Dr Shah holds an applied research chair in Reproductive and Child Health Services and Policy Research awarded by the Canadian Institutes of Health Research (APR-126340).

Author contributions

The first draft of this manuscript was written by JYT. All authors take responsibility for the reported findings and have participated in the concept and design, analysis and interpretation of data, drafting or revising, and approval of this manuscript as submitted. No honorarium, grant or other form of payment was given to anyone to write the manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada

    Joseph Y. Ting & Anne R. Synnes

  2. Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada

    Shoo K. Lee & Prakesh S. Shah

  3. Department of Pediatrics, University of Toronto, Toronto, ON, Canada

    Shoo K. Lee & Prakesh S. Shah

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  1. Joseph Y. Ting
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on behalf of the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network

Corresponding author

Correspondence to Prakesh S. Shah.

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The authors declare that they have no conflict of interest.

Additional information

Group Information: Investigators of the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network are listed in the online supplement (Appendix; online).

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Ting, J.Y., Synnes, A., Lee, S.K. et al. Association of admission temperature and death or adverse neurodevelopmental outcomes in extremely low-gestational age neonates. J Perinatol 38, 844–849 (2018). https://doi.org/10.1038/s41372-018-0099-6

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