Outcomes of neonatal hypothermia among very low birth weight infants: a Meta-analysis

Sagad Omer Obeid Mohamed,Sara Mohamed Ibrahim Ahmed,Basil Abubakr Yagoub Ibrahim,Reem Jamal Yousif Khidir,Esra Osama Abdelrahman Elmahdi,Mutaz Tarig Hassan Ahmed Shaheen,Mosab Hussen Mostafa Adam,Abubaker Shadoul Mohamed Farah

doi:10.1186/s40748-021-00134-6

Sagad Omer Obeid Mohamed, Sara Mohamed Ibrahim Ahmed + Show 6 more

Open Access

https://doi.org/10.1186/s40748-021-00134-6

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Abstract

BackgroundNeonatal 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.MethodsIn 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).ResultsEighteen 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).ConclusionNeonatal 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.

Highlights

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
Studies characteristics and prevalence of HT among very low birth weight (VLBW) infants Our search retrieved records for 1840 published articles and the records screened after the removal of duplicates were 1438 articles
Among the 40,136 VLBW infants included in the analysis, the pooled prevalence of HT among VLBW infants was 48.3% (Fig. 2)

Summary

Introduction

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. 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. Low birth weight accounts for 60–80% of all neonatal deaths [2]. Several studies have reported an association between neonatal admission hypothermia (HT) and increased risk of mortality and morbidity in VLBW infants [5–13]. These outcomes associated with HT are evident in VLBW newborns due to their impaired and overwhelmed temperature regulatory mechanism, which is mainly due to high surface area to mass ratio, decreased subcutaneous fat, lack of shivering response, and inadequate brown fat [2, 10–12]. Laptook et al found in an adjusted analysis that with each 1 °C decrease in body temperature of VLBW infants, sepsis and mortality risks increase by 11 and 28%, respectively [13]

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