Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study

Abstract

Background: The objective of this prospective, multicentre, observational cohort study was to evaluate the association between admission hypothermia and neonatal outcomes in very low-birth weight (VLBW) infants in multiple neonatal intensive care units (NICUs) in China. Methods: Since January 1, 2018, a neonatal homogeneous cooperative research platform-Shandong Neonatal Network (SNN) has been established. The platform collects clinical data in a prospective manner on preterm infants with birth weights (BWs) < 1500 g and gestational ages (GAs) < 34 weeks born in 28 NICUs in Shandong Province. These infants were divided into normothermia, mild or moderate/severe hypothermia groups according to the World Health Organization (WHO) classifications of hypothermia. Associations between outcomes and hypothermia were tested in a bivariate analysis, followed by a logistic regression analysis.

A Standardized Implementation of Multicenter Quality Improvement Program of Very Low Birth Weight Newborns Could Significantly Reduce Admission Hypothermia and Improve Outcomes Within a Certain Region in China

“…Researches showed AH is an independent risk factor for neonatal mortality and morbidity, associated with a high likelihood of IVH and LOS [5]. Recognizing the current state of hypothermia in units is conducive to sounding the alarm to medical personnel, prompting them to make efforts to nd the cause, strengthen the awareness of disease, contributed to implementing targeted clinical quality improvement, accordingly, enhancing quality of care and improving clinical neonatal outcomes [13-17, 25, 37].…”

“…The admission temperatures related data of VLBW infants were collected prospectively in SNN. The database provided maternal, delivery, neonatal clinical materials and temperature data before discharge, and the data were collected by a standardized operating procedure [5,18,34]. The admission temperature was de ned as the infant's rectal temperature measured at admission to the NICU within 1 h after birth, because it's closer to core temperature [35].…”

“…besides, lack of attention paid by medical staff, and insu cient execution were also founded to be the main contributors [5][6].…”

“…Researches showed AH, especially AMSH is an independent risk factor for neonatal mortality and morbidity, connected with respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH) and late-onset neonatal sepsis (LOS). [5,[7][8][9][10][11]. In 2014, a practical scienti c point of view put forward, a theory of building in mechanisms to prompt re ection on your work, every day, seeking and incorporating feedback from others on team, began to be accepted by the public [12].…”

Targeted Quality Improvement Project&nbsp;Dramatically Reduced Admission Hypothermia in Very Low Birth Weight Infant&nbsp;in China: A Multicentre Study

“…Internationally, the thermoregulation guidelines involved multiple modalities divided into four phases: predelivery preparation, resuscitation, transfer, and NICU admission [10][11][12][13][14]. But the proportion of admission hypothermia was still higher in clinical practice.…”