Background Neonatal admission hypothermia (HT) is a frequently encountered problem in neonatal intensive care units (NICUs) and it has been linked to a higher risk of mortality and morbidity. However, there is a disparity in data in the existing literature regarding the prevalence and outcomes associated with HT in very low birth weight (VLBW) infants. This review aimed to provide further summary and analyses of the association between HT and adverse clinical outcomes in VLBW infants. Methods In July 2020, we conducted this review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic database search was conducted in MEDLINE (PubMed), Google Scholar, ScienceDirect, World Health Organization Virtual Health Library, Cochrane Library databases, and System for Information on Grey Literature in Europe (SIGLE). We included studies that assessed the prevalence of HT and/or the association between HT and any adverse outcomes in VLBW infants. We calculated the pooled prevalence and Odds Ratio (OR) estimates with the corresponding 95% Confidence Interval (CI) using the Comprehensive meta-analysis software version 3.3 (Biostat, Engle-wood, NJ, USA; http://www.Meta-Analysis.com). Results Eighteen studies that fulfilled the eligibility criteria were meta-analyzed. The pooled prevalence of HT among VLBW infants was 48.3% (95% CI, 42.0–54.7%). HT in VLBW infants was significantly associated with mortality (OR = 1.89; 1.72–2.09), intra-ventricular hemorrhage (OR = 1.86; 1.09–3.14), bronchopulmonary dysplasia (OR = 1.28; 1.16–1.40), neonatal sepsis (OR = 1.47; 1.09–2.49), and retinopathy of prematurity (OR = 1.45; 1.28–1.72). Conclusion Neonatal HT rate is high in VLBW infants and it is a risk factor for mortality and morbidity in VLBW infants. This review provides a comprehensive view of the prevalence and outcomes of HT in VLBW infants.

with chronic headache, and 3/35 (9%) were diagnosed with non-specific headache. None were diagnosed with tension-type headache.15/35 (44%) had a head MRI, which was normal in all.Only 5/35 (14%) patients were recommended a headache diary. 3/8 (38%) with migraine and one patient whose headache was not classified were given duo-therapy consisting of a triptan and NSAID. A further 2/8 (25%) with migraine, and two patients whose headaches were not classified, were prescribed a triptan. Five patients without a headache diagnosis, three with chronic headache, one with migraine, one with secondary headache, one with non-specific headache were treated with NSAIDs only. 3/8 (38%) patients with migraines, six with undiagnosed headache, and one with chronic headache were given pizotifen prophylaxis.Advice about Medication Overuse Headache was documented in six patients. 9/35 (26%), including 4/8 (50%) patients with migraine, four with unclassified headache, and one with non-specific headache were discharged after the initial consult. 2/35 (6%), including one patient with secondary headache, and one nonspecific headache were referred to tertiary care after initial consult.The mean follow-up period after initial consult was nine months. 1/8 (13%) patients with migraine, and seven patients with unclassified headache were discharged after the first follow-up; 1/8 (13%) with migraine, two with unclassified headache, and two patients with chronic headache were discharged after the second follow-up. One patient with unclassified headache was discharged after the third follow-up. Six patients did not have their headaches discussed in subsequent visits and three patients are still being followed-up. Two patients have been lost to follow up.15/22 (68%) evaluable, who had a follow-up, experienced an improvement in their symptoms. Conclusions There was a good attempt at describing headaches, but many patients were not given a specific diagnosis as recommended by NICE. Also, fewer patients should have undergone brain imaging, more should have had advice about using headache diaries, and Medication Overuse Headache. We recommend a template to help diagnose and manage headaches in the clinic and a remote follow-up system for patients after discharge.

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