Abstract
Background: Among term infants, hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood. Treatment is currently limited to supportive intensive care, without any specific brain-oriented therapy.
 Objective: To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature between 12 and 72 hours of birth.
 Materials and Methods: This was a prospective observational study. Asphyxiated newborns who came within 12 hours of birth were enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours and each infant`s temperature for each site were rank ordered. Then mean of all axillary and rectal temperatures of each neonate was calculated. Outcomes were related to temperatures in logistic regression analyses for the elevated/relatively high temperatures and normal/low temperatures group, with adjustment of the level of encephalopathy and gender.
 Results: The mean axillary temperature was 36.07 ± 6.10C and in 25.71%, 11.92% and 6.32% cases axillary temperatures were >370C, >37.50C and >380C respectively. The mean rectal temperature was 36.8 ± 60C, and in 43.53%, 30.02% and 19.97% cases rectal temperatures were >370C, >37.50C and >380C respectively. Mean ambient temperature was 26.170C. There was significant correlation between axillary and rectal temperatures (r=0.889). For elevated temperature, the odds of death or moderate to severe impairment increased 8.9-fold (CI 0.906–88.18) and the odds of death alone increased 4.6-fold (CI 0.373–56.83). The odds of impairment increased 1.84-fold (CI 0.45– 7.50).
 Conclusion: Relatively high temperature during usual care after hypoxic-ischemia in term neonates was associated with adverse neurodevelopmental outcomes.
 J Enam Med Col 2019; 9(3): 160-165
Highlights
Among term infants, hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood
All the admitted term newborns who came within 12 hours of birth with history of perinatal asphyxia having features of hypoxic-ischemic encephalopathy were included in this study
The study included 60 neonates suffering from hypoxic-ischemic encephalopathy of different stages and treated in Neonatal ICU of Dhaka Shishu Hospital and Dhaka Medical College Hospital
Summary
Hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood. Objective: To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature between 12 and 72 hours of birth. Asphyxiated newborns who came within 12 hours of birth were enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours and each infants temperature for each site were rank ordered. Mean of all axillary and rectal temperatures of each neonate was calculated. Conclusion: Relatively high temperature during usual care after hypoxic-ischemia in term neonates was associated with adverse neurodevelopmental outcomes
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