Admission temperature and neonatal outcomes - single-centre experience in Saudi Arabia

Fneish, Ammar; Alhasoon, Mohammad A; Essa, Amenah Al; Mahlangu, Radha; Alshami, Noura; Alsaif, Saif; Ali, Kamal

doi:10.1016/j.ijpam.2022.12.001

Cited by 5 publications

(1 citation statement)

References 22 publications

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“…Some studies have found no association between admission hypothermia and IVH. 21 32 33 The results of one meta-analysis showed that the risk of NEC among very low birth weight infants with and without hypothermia was not significantly different between the two groups. 34 de Siqueira Caldas et al 35 showed that mildly induced therapeutic admission hypothermia may have a protective effect against NEC in preterm infants.…”

Section: Discussionmentioning

confidence: 99%

Association between Neonatal Outcomes and Admission Hypothermia among Very Preterm Infants in Chinese Neonatal Intensive Care Units: A Multicenter Cohort Study

Hong,

Zhu,

Wang

et al. 2024

Am J Perinatol

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Objective We aimed to investigate the relationship between admission hypothermia and outcomes among very preterm infants (VPIs) in neonatal intensive care units (NICUs) in China. We also investigated the frequency of hypothermia in VPIs in China and the variation in hypothermia across Chinese Neonatal Network (CHNN) sites. Study Design This retrospective cohort study enrolled infants with 240/7 to 316/7 weeks of gestation with an admission body temperature ≤37.5 °C who were admitted to CHNN-participating NICUs between January 1 and December 31, 2019. Results A total of 5,913 VPIs were included in this study, of which 4,075 (68.9%) had hypothermia (<36.5 °C) at admission. The incidence of admission hypothermia varied widely across CHNN sites (9–100%). Lower gestational age (GA), lower birth weight, antenatal steroid administration, multiple births, small for GA, Apgar scores <7 at the 5th minute, and intensive resuscitation were significantly associated with admission hypothermia. Compared with infants with normothermia (36.5–37.5 °C), the adjusted odds ratios (ORs) for composite outcome among infants with admission hypothermia <35.5 °C increased to 1.47 (95% confidence interval [CI], 1.15–1.88). The adjusted ORs for mortality among infants with admission hypothermia (36.0–36.4 and <35.5 °C) increased to 1.41 (95% CI, 1.09–1.83) and 1.93 (95% CI, 1.31–2.85), respectively. Admission hypothermia was associated with a higher likelihood of bronchopulmonary dysplasia, but was not associated with necrotizing enterocolitis ≥stage II, severe intraventricular hemorrhage, cystic periventricular leukomalacia, severe retinopathy of prematurity, or sepsis. Conclusion Admission hypothermia remains a common problem for VPIs in a large cohort in China and is associated with adverse outcomes. Continuous quality improvement of admission hypothermia in the future may result in a substantial improvement in the outcomes of VPIs in China. Key Points

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Section: Discussionmentioning

confidence: 99%

Association between Neonatal Outcomes and Admission Hypothermia among Very Preterm Infants in Chinese Neonatal Intensive Care Units: A Multicenter Cohort Study

Hong,

Zhu,

Wang

et al. 2024

Am J Perinatol

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Two risk assessment models for predicting white matter injury in extremely preterm infants

Song,

Zhu,

Zhang

et al. 2024

Pediatr Res

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Comparative evaluation of axillary and rectal temperatures across different gestational ages in newborns admitted to the neonatal intensive care unit: a cross-sectional study

Halabi,

Almuqati,

Al Essa

et al. 2024

BMC Pediatr

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Objective Maintaining normothermia is crucial for neonatal survival, especially in preterm infants prone to temperature instability. This study evaluates the correlation and variability between axillary and rectal temperatures at Neonatal Intensive Care (NICU) admission across gestational age ranges of 23–28, 29–32, 33–36, and ≥ 37 weeks, aiming to inform improved neonatal thermal management strategies. Methods This cross-sectional study was conducted at King Abdulaziz Medical City, Riyadh, from October 2023 to April 2024, involving 160 infants. Admission temperatures were measured using digital thermometers. Data analysis included ANOVA/Kruskal-Wallis for continuous variables, Chi-square tests for categorical data, Bland-Altman method for agreement assessment, and Pearson correlation coefficients to evaluate temperature correlations. Results Mean axillary temperature increased from 36.4 °C in the 23–28 weeks gestational group, to 36.5 °C in the 29–32 weeks group, and to 36.7 °C in the 33–36 weeks and ≥ 37 weeks groups, ( p = 0.033). Rectal temperature increased from 36.5 °C in the 23–28 weeks group, to 36.6 °C in the 29–32 weeks group, and reached 36.8 °C in both the 33–36 weeks and ≥ 37 weeks groups ( p = 0.006). Notable differences between measurement methods were observed in the 33–36 and ≥ 37 weeks groups ( p < 0.001), with less pronounced differences in the 23–28 and 29–32 weeks groups. While temperature differences between rectal and axillary measurements remained consistent across all groups at 0.1 °C ( p = 0.779), neonatal outcomes varied significantly across gestational age groups, with younger infants exhibiting lower survival rates ( p < 0.001), higher incidences of hypoglycemia ( p < 0.001) and sepsis ( p < 0.001), and extended durations of ventilation ( p < 0.001) and hospital stay ( p < 0.001). Strong correlations between rectal and axillary temperature were found across all age ranges (Pearson coefficients: 0.953 for 23–28 weeks, 0.762 for 29–32 weeks, 0.910 for 33–36 weeks, and 0.761 for ≥ 37 weeks; all p < 0.001). Bland-Altman analysis indicated higher variability in agreement for younger preterm groups, showing limits of agreement ranging from − 0.5 to 0.65 °C for 23–28 weeks and − 0.5 to 0.69 °C for 29–32 weeks, improving in older groups with − 0.2 to 0.4 °C for 33–36 weeks and similarly narrow ranges for ≥ 37 weeks. Conclusion Both rectal and axillary temperatures showed variation across different age groups, exhibiting a substantial overall correlation. Notable differences between the two methods were observed in the 33–36 weeks and ≥ 37 weeks groups. Younger preterm infants demonstrated greater variability, with enhanced a...

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Admission temperature and neonatal outcomes - single-centre experience in Saudi Arabia

Cited by 5 publications

References 22 publications

Association between Neonatal Outcomes and Admission Hypothermia among Very Preterm Infants in Chinese Neonatal Intensive Care Units: A Multicenter Cohort Study

Association between Neonatal Outcomes and Admission Hypothermia among Very Preterm Infants in Chinese Neonatal Intensive Care Units: A Multicenter Cohort Study

Two risk assessment models for predicting white matter injury in extremely preterm infants

Comparative evaluation of axillary and rectal temperatures across different gestational ages in newborns admitted to the neonatal intensive care unit: a cross-sectional study

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