Hypothermia at NICU admission in very preterm infants

Abstract

Since the reports by Silverman et al reporting that hypothermia was associated with increased mortality in preterm infants, neonatologists have tried to effectively regulate body temperature. The challenge that remains is that the smallest and most premature infants continue to have hypothermia on admission to the neonatal intensive care unit. In this volume of The Journal, Wilson et al report that hypothermia occurred in 53.4% of 5697 infants born at <32 weeks gestational age in a population-based study with samples from 11 European countries. More concerning is that 12.9% of the population had admission temperatures below 35.5°C. Thus, despite the recent focus on developing and testing new approaches to better maintain body temperature in this very high risk population, temperatures often were quite low soon after birth. In this large population, a low initial temperature was associated with increased death at 1 to 6 days and 7 to 28 days of age despite multiple adjustments for variables likely linked to low body temperature. Because later deaths with hypothermia were not associated with low Apgar scores or other complications of prematurity, the effect of admission temperature may not be explained by an association of low body temperature with a less favorable clinical status at birth. The causal link between hypothermia and mortality remains unexplained, but hypothermia following very preterm delivery is a preventable “disease” that requires constant attention to prevent. Article page 61▶ Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and MorbidityThe Journal of PediatricsVol. 175PreviewTo investigate the association between body temperature at admission to neonatal intensive care and in-hospital mortality in very preterm infants, stratified by postnatal age of death. Moreover, we assessed the association between admission temperature and neonatal morbidity. Full-Text PDF