Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Extremely low birth weight preterm infants lack vasomotor response in relationship to cold body temperatures at birth

Journal of Perinatology volume 29, pages 814–821 (2009)Cite this article

Abstract

Study Objective:

This study evaluated peripheral vasoconstriction in extremely low birth weight (ELBW) infants when body temperature decreased during the first 12 h of life.

Study Design:

An exploratory, within-subjects design with 10 ELBW infants. Abdominal and foot temperatures were measured every minute. Peripheral vasoconstriction (abdominal>peripheral temperature by 2 °C) and abdominal–peripheral temperature difference were also evaluated. Results:Abdominal and peripheral temperatures were significantly correlated within each infant. One 880 g infant exhibited isolated peripheral vasoconstriction; a 960-g infant had abdominal temperatures >1 °C higher than peripheral temperatures. Eight smaller infants exhibited no peripheral vasoconstriction and spent most of their observations with peripheral greater than abdominal temperatures. In eight infants, mean temperature difference was significantly higher when abdominal temperature was <36.5 °C.

Conclusion:

Most ELBW infants did not exhibit peripheral vasoconstriction during their first 12 h of life, despite low temperatures. ELBW infants’ vasomotor control may be immature during this period.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Knobel R, Holditch-Davis D . Themoregulation and heat loss prevention after birth and during neonatal intensive-care unit stabilization of extremely-low-birth weight infants. J Obstet Gynecol Neonatal Nurs 2007; 36: 280–287.

    Article  Google Scholar 

  2. Thomas K . Preterm infant thermal responses to caregiver differ by incubator control mode. J Perinatol 2003; 23: 640–645.

    Article  Google Scholar 

  3. Buetow K, Klein S . Effect of maintenance of ‘normal’ skin temperature on survival of infants of low birth weight. Pediatrics 1964; 34: 163–170.

    CAS  PubMed  Google Scholar 

  4. Day R, Caliguiri L, Kamenski C, Ehrlich F . Body temperature and survival of premature infants. Pediatrics 1964; 34: 171–181.

    CAS  PubMed  Google Scholar 

  5. Hazan J, Maag U, Chessex P . Association between hypothermia and mortality rate of premature infant—revisited. Am J Obstet Gynecol 1991; 164: 111–112.

    Article  CAS  Google Scholar 

  6. Vohra S, Grent G, Campbell V, Abbott M, Whyte R . Effect of polyethylene occlusive skin wrapping on heat loss in very low birth weight infants at delivery: a randomized trial. J Pediatr 1999; 134: 547–551.

    Article  CAS  Google Scholar 

  7. Hull D, Smales O . Heat production in the newborn. In: Sinclair J (ed). Temperature Regulation and Energy Metabolism in the Newborn. Gurne & Stratton: New York, 1978. pp 129–156.

    Google Scholar 

  8. Houstek J, Vizek K, Pavelka S, Kopecky J, Krejcova E, Hermanska J . Type II iodothyronine 5′-deiodinase and uncoupling protein in brown adipose tissue of human newborns. J Clin Endocrinol Metab 1993; 77: 382–387.

    CAS  PubMed  Google Scholar 

  9. Lyon A, Pikaar M, Badger P, McIntosh N . Temperature control in very low birthweight infants during first five days of life. Arch Dis Child Fetal Neonatal Ed 1997; 76: F47–F50.

    Article  CAS  Google Scholar 

  10. Horns K . Comparison of two microenvironments and nurse caregiving on thermal stability of ELBW infants. Adv Neonatal Care 2002; 2 (3): 149–160.

    Article  Google Scholar 

  11. Mok Q, Bass C, Ducker D, McIntosh N . Temperature instability during nursing procedures in preterm neonates. Arch Dis Child 1991; 66: 783–786.

    Article  CAS  Google Scholar 

  12. Bailey J, Rose P . Temperature measurement in the preterm infant: a literature review. J Neonatal Nurs 2000; 6: 28–32.

    Google Scholar 

  13. Simbrunner G . Temperature measurements and distribution of temperatures throughout the body in neonates. In: Okken A, Koch J (eds). Thermoregulation of Sick and Low Birth Weight Neonates. Springer-Verlag Berlin: Germany, 1995. pp 53–62.

    Chapter  Google Scholar 

  14. Harpin VA, Rutter N . Development of emotional sweating in the newborn infant. Arch Dis Child 1982; 57: 691–695.

    Article  CAS  Google Scholar 

  15. Sanders M, Allen M, Alexander G, Yankowitz J, Graeber J, Johnson TR et al. Gestational age assessment in preterm neonates weighing less than 1500 grams. Pediatrics 1991; 88: 542–546.

    CAS  PubMed  Google Scholar 

  16. Longin E, Gerstner T, Schaible T, Lenz T, Konig S . Maturation of the autonomic nervous system: differences in heart rate variability in premature vs term infants. J Perinat Med 2006; 34 (4): 303–308.

    Article  Google Scholar 

  17. Gournay V, Drouin E, Roze JC . Development of baroflex control of heart rate in preterm and full term infants. Arch Dis Child Fetal Neonatal Ed 2002; 86 (3): F151–F154.

    Article  CAS  Google Scholar 

  18. Allen MC . Assessment of gestational age and neuromaturation. Ment Retard Dev Disabil Res Rev 2005; 11: 21–33.

    Article  Google Scholar 

  19. Osborn DA, Evans N, Kluckow M . Hemodynamic and antecedent risk factors of early and late periventricular/intraventricular hemorrhage in premature infants. Pediatrics 2003; 112: 33–39.

    Article  Google Scholar 

  20. Paulson O, Strandgaard S, Edvinsson L . Cerebral autoregulation. Cerebrovasc Brain Metab Rev 1990; 2: 161–192.

    CAS  PubMed  Google Scholar 

  21. Kehrer M, Blumenstock G, Ehehalt S, Goelz R, Poets C, Schoning M . Development of cerebral blood flow volume in preterm neonates during the first two weeks of life. Pediatr Res 2005; 58: 927–930.

    Article  Google Scholar 

  22. Meek J, Tyszczuk L, Elwell C, Wyatt J . Cerebral blood flow increases over the first three days of life in extremely preterm neonates. Arch Dis Child Fetal Neonatal Ed 1998; 78: F33–F37.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank the parents of the infants in this study for consenting to the study, as they anticipated the arrival of their preterm infant and the nurses, respiratory therapists, and doctors that worked with these infants at Pitt County Memorial Hospital in Greenville, NC. I also thank Dr Virginia Neelon, Dr Suzanne Thoyre, and John White for their thoughtful contributions to this study. Funding support was provided by National Service Research Award, 1F31 NR09143 from the National Institute of Nursing Research, NIH; American Nurses Foundation: Nurses Charitable Trust District V FNA Scholar Research Grant; and Foundation of Neonatal Research and Education Grant.

Author information

Authors and Affiliations

  1. Duke University School of Nursing, Durham, NC, USA

    R B Knobel & D Holditch-Davis

  2. Department of Biostatistics, School of Public Heath and School of Nursing, University of North Carolina, Chapel Hill, NC, USA

    T A Schwartz

  3. Women's Hospital of Greensboro, Moses Cone Health System, NC, USA

    J E Wimmer Jr

Authors
  1. R B Knobel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D Holditch-Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T A Schwartz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J E Wimmer Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R B Knobel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Knobel, R., Holditch-Davis, D., Schwartz, T. et al. Extremely low birth weight preterm infants lack vasomotor response in relationship to cold body temperatures at birth. J Perinatol 29, 814–821 (2009). https://doi.org/10.1038/jp.2009.99

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2009.99

Keywords

This article is cited by

Search

Advanced search

Quick links