Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

Emilija Wilson; Mikael Norman; Emilija Wilson; Mikael Norman; Emilija Wilson; Rolf F. Maier; Bjoern Misselwitz; Elizabeth A. Howell; Elizabeth A. Howell; Elizabeth A. Howell; Jennifer Zeitlin; Jennifer Zeitlin; Anna Karin Bonamy; Anna Karin Bonamy; Patrick Van Reempts; Evelyne Martens; Guy Martens; Ole Pryds; Klaus Boerch; Asbjoern Hasselager; Lene Huusom; Tom Weber; Liis Toome; Heili Varendi; Patrick Truffert; Pierre Henri Jarreau; Pierre Yves Ancel; Beatrice Blondel; Antoine Burguet; Stephan Schmidt; Ludwig Gortner; Marina Cuttini; Ileana Croci; Dante Baronciani; Giancarlo Gargano; Virgilio Carnielli; Domenico Di Lallo; Rocco Agostino; Francesco Franco; Corine Koopman-Esseboom; Joppe Nijman; Arno van Heijst; Janusz Gadzinowski; Jan Mazela; Luis M. Graça; Maria Ceu Machado; Rui Carapato; Henrique Barros; Carina Rodrigues; Teresa Rodrigues; Elizabeth Draper; Elaine M. Boyle; Brad Manktelow; David W A Milligan; Alan Fenton

doi:10.1016/j.jpeds.2016.04.016

Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

Emilija Wilson, Mikael Norman, Emilija Wilson, Mikael Norman, Emilija Wilson, Rolf F. Maier, Bjoern Misselwitz, Elizabeth A. Howell, Elizabeth A. Howell, Elizabeth A. Howell, Jennifer Zeitlin, Jennifer Zeitlin, Anna Karin Bonamy, Anna Karin Bonamy, Patrick Van Reempts, Evelyne Martens, Guy Martens, Ole Pryds, Klaus Boerch, Asbjoern HasselagerLene Huusom, Tom Weber, Liis Toome, Heili Varendi, Patrick Truffert, Pierre Henri Jarreau, Pierre Yves Ancel, Beatrice Blondel, Antoine Burguet, Stephan Schmidt, Ludwig Gortner, Marina Cuttini, Ileana Croci, Dante Baronciani, Giancarlo Gargano, Virgilio Carnielli, Domenico Di Lallo, Rocco Agostino, Francesco Franco, Corine Koopman-Esseboom, Joppe Nijman, Arno van Heijst, Janusz Gadzinowski, Jan Mazela, Luis M. Graça, Maria Ceu Machado, Rui Carapato, Henrique Barros, Carina Rodrigues, Teresa Rodrigues, Elizabeth Draper, Elaine M. Boyle, Brad Manktelow, David W A Milligan, Alan Fenton

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective

To 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.

Study design

In this cohort study from 19 regions in 11 European countries, we measured body temperature at admission for infants admitted for neonatal care after very preterm birth (<32 weeks of gestation; n = 5697) who were followed to discharge or death. Associations between body temperature at admission and in-hospital mortality and neonatal morbidity were analyzed by the use of mixed effects generalized linear models. The final model adjusted for pregnancy complications, singleton or multiple pregnancy, antenatal corticosteroids, mode of delivery, gestational age, infant size and sex, and Apgar score <7 at 5 minutes.

Results

A total of 53.4% of the cohort had a body temperature at admission less than 36.5°C, and 12.9% below 35.5°C. In the adjusted model, an admission temperature <35.5°C was associated with increased mortality at postnatal ages 1-6 days, (risk ratio 2.41; 95% CI 1.45-4.00), and 7-28 days (risk ratio 1.79; 1.15-2.78) but not after 28 days of age. We found no associations between admission temperature and neonatal morbidity.

Conclusion

Admission hypothermia after very preterm birth is a significant problem in Europe, associated with an increased risk of early and late neonatal death.

Original language	English
Pages (from-to)	61-67.e4
Journal	Journal of Pediatrics
Volume	175
DOIs	https://doi.org/10.1016/j.jpeds.2016.04.016
Publication status	Published - 1 Aug 2016

Keywords

epidemiology
neonatal intensive care
very preterm birth

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10.1016/j.jpeds.2016.04.016

Cite this

Wilson, E., Norman, M., Wilson, E., Norman, M., Wilson, E., Maier, R. F., Misselwitz, B., Howell, E. A., Howell, E. A., Howell, E. A., Zeitlin, J., Zeitlin, J., Bonamy, A. K., Bonamy, A. K., Van Reempts, P., Martens, E., Martens, G., Pryds, O., Boerch, K., ... Fenton, A. (2016). Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity. Journal of Pediatrics, 175, 61-67.e4. https://doi.org/10.1016/j.jpeds.2016.04.016

@article{80999c0636be4e7a8c6f3baff2ee4036,

title = "Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity",

abstract = "ObjectiveTo 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.Study designIn this cohort study from 19 regions in 11 European countries, we measured body temperature at admission for infants admitted for neonatal care after very preterm birth (<32 weeks of gestation; n = 5697) who were followed to discharge or death. Associations between body temperature at admission and in-hospital mortality and neonatal morbidity were analyzed by the use of mixed effects generalized linear models. The final model adjusted for pregnancy complications, singleton or multiple pregnancy, antenatal corticosteroids, mode of delivery, gestational age, infant size and sex, and Apgar score <7 at 5 minutes.ResultsA total of 53.4% of the cohort had a body temperature at admission less than 36.5°C, and 12.9% below 35.5°C. In the adjusted model, an admission temperature <35.5°C was associated with increased mortality at postnatal ages 1-6 days, (risk ratio 2.41; 95% CI 1.45-4.00), and 7-28 days (risk ratio 1.79; 1.15-2.78) but not after 28 days of age. We found no associations between admission temperature and neonatal morbidity.ConclusionAdmission hypothermia after very preterm birth is a significant problem in Europe, associated with an increased risk of early and late neonatal death.",

keywords = "epidemiology, neonatal intensive care, very preterm birth",

author = "Emilija Wilson and Mikael Norman and Emilija Wilson and Mikael Norman and Emilija Wilson and Maier, {Rolf F.} and Bjoern Misselwitz and Howell, {Elizabeth A.} and Howell, {Elizabeth A.} and Howell, {Elizabeth A.} and Jennifer Zeitlin and Jennifer Zeitlin and Bonamy, {Anna Karin} and Bonamy, {Anna Karin} and {Van Reempts}, Patrick and Evelyne Martens and Guy Martens and Ole Pryds and Klaus Boerch and Asbjoern Hasselager and Lene Huusom and Tom Weber and Liis Toome and Heili Varendi and Patrick Truffert and Jarreau, {Pierre Henri} and Ancel, {Pierre Yves} and Beatrice Blondel and Antoine Burguet and Stephan Schmidt and Ludwig Gortner and Marina Cuttini and Ileana Croci and Dante Baronciani and Giancarlo Gargano and Virgilio Carnielli and {Di Lallo}, Domenico and Rocco Agostino and Francesco Franco and Corine Koopman-Esseboom and Joppe Nijman and {van Heijst}, Arno and Janusz Gadzinowski and Jan Mazela and Gra{\c c}a, {Luis M.} and {Ceu Machado}, Maria and Rui Carapato and Henrique Barros and Carina Rodrigues and Teresa Rodrigues and Elizabeth Draper and Boyle, {Elaine M.} and Brad Manktelow and Milligan, {David W A} and Alan Fenton",

year = "2016",

month = aug,

day = "1",

doi = "10.1016/j.jpeds.2016.04.016",

language = "English",

volume = "175",

pages = "61--67.e4",

journal = "Journal of Pediatrics",

issn = "0022-3476",

publisher = "Mosby Inc.",

}

Wilson, E, Norman, M, Wilson, E, Norman, M, Wilson, E, Maier, RF, Misselwitz, B, Howell, EA, Howell, EA, Howell, EA, Zeitlin, J, Zeitlin, J, Bonamy, AK, Bonamy, AK, Van Reempts, P, Martens, E, Martens, G, Pryds, O, Boerch, K, Hasselager, A, Huusom, L, Weber, T, Toome, L, Varendi, H, Truffert, P, Jarreau, PH, Ancel, PY, Blondel, B, Burguet, A, Schmidt, S, Gortner, L, Cuttini, M, Croci, I, Baronciani, D, Gargano, G, Carnielli, V, Di Lallo, D, Agostino, R, Franco, F, Koopman-Esseboom, C, Nijman, J, van Heijst, A, Gadzinowski, J, Mazela, J, Graça, LM, Ceu Machado, M, Carapato, R, Barros, H, Rodrigues, C, Rodrigues, T, Draper, E, Boyle, EM, Manktelow, B, Milligan, DWA & Fenton, A 2016, 'Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity', Journal of Pediatrics, vol. 175, pp. 61-67.e4. https://doi.org/10.1016/j.jpeds.2016.04.016

TY - JOUR

T1 - Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

AU - Wilson, Emilija

AU - Norman, Mikael

AU - Wilson, Emilija

AU - Norman, Mikael

AU - Wilson, Emilija

AU - Maier, Rolf F.

AU - Misselwitz, Bjoern

AU - Howell, Elizabeth A.

AU - Zeitlin, Jennifer

AU - Bonamy, Anna Karin

AU - Van Reempts, Patrick

AU - Martens, Evelyne

AU - Martens, Guy

AU - Pryds, Ole

AU - Boerch, Klaus

AU - Hasselager, Asbjoern

AU - Huusom, Lene

AU - Weber, Tom

AU - Toome, Liis

AU - Varendi, Heili

AU - Truffert, Patrick

AU - Jarreau, Pierre Henri

AU - Ancel, Pierre Yves

AU - Blondel, Beatrice

AU - Burguet, Antoine

AU - Schmidt, Stephan

AU - Gortner, Ludwig

AU - Cuttini, Marina

AU - Croci, Ileana

AU - Baronciani, Dante

AU - Gargano, Giancarlo

AU - Carnielli, Virgilio

AU - Di Lallo, Domenico

AU - Agostino, Rocco

AU - Franco, Francesco

AU - Koopman-Esseboom, Corine

AU - Nijman, Joppe

AU - van Heijst, Arno

AU - Gadzinowski, Janusz

AU - Mazela, Jan

AU - Graça, Luis M.

AU - Ceu Machado, Maria

AU - Carapato, Rui

AU - Barros, Henrique

AU - Rodrigues, Carina

AU - Rodrigues, Teresa

AU - Draper, Elizabeth

AU - Boyle, Elaine M.

AU - Manktelow, Brad

AU - Milligan, David W A

AU - Fenton, Alan

PY - 2016/8/1

Y1 - 2016/8/1

N2 - ObjectiveTo 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.Study designIn this cohort study from 19 regions in 11 European countries, we measured body temperature at admission for infants admitted for neonatal care after very preterm birth (<32 weeks of gestation; n = 5697) who were followed to discharge or death. Associations between body temperature at admission and in-hospital mortality and neonatal morbidity were analyzed by the use of mixed effects generalized linear models. The final model adjusted for pregnancy complications, singleton or multiple pregnancy, antenatal corticosteroids, mode of delivery, gestational age, infant size and sex, and Apgar score <7 at 5 minutes.ResultsA total of 53.4% of the cohort had a body temperature at admission less than 36.5°C, and 12.9% below 35.5°C. In the adjusted model, an admission temperature <35.5°C was associated with increased mortality at postnatal ages 1-6 days, (risk ratio 2.41; 95% CI 1.45-4.00), and 7-28 days (risk ratio 1.79; 1.15-2.78) but not after 28 days of age. We found no associations between admission temperature and neonatal morbidity.ConclusionAdmission hypothermia after very preterm birth is a significant problem in Europe, associated with an increased risk of early and late neonatal death.

AB - ObjectiveTo 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.Study designIn this cohort study from 19 regions in 11 European countries, we measured body temperature at admission for infants admitted for neonatal care after very preterm birth (<32 weeks of gestation; n = 5697) who were followed to discharge or death. Associations between body temperature at admission and in-hospital mortality and neonatal morbidity were analyzed by the use of mixed effects generalized linear models. The final model adjusted for pregnancy complications, singleton or multiple pregnancy, antenatal corticosteroids, mode of delivery, gestational age, infant size and sex, and Apgar score <7 at 5 minutes.ResultsA total of 53.4% of the cohort had a body temperature at admission less than 36.5°C, and 12.9% below 35.5°C. In the adjusted model, an admission temperature <35.5°C was associated with increased mortality at postnatal ages 1-6 days, (risk ratio 2.41; 95% CI 1.45-4.00), and 7-28 days (risk ratio 1.79; 1.15-2.78) but not after 28 days of age. We found no associations between admission temperature and neonatal morbidity.ConclusionAdmission hypothermia after very preterm birth is a significant problem in Europe, associated with an increased risk of early and late neonatal death.

KW - epidemiology

KW - neonatal intensive care

KW - very preterm birth

UR - http://www.scopus.com/inward/record.url?scp=84966736544&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2016.04.016

DO - 10.1016/j.jpeds.2016.04.016

M3 - Article

C2 - 27189680

AN - SCOPUS:84966736544

SN - 0022-3476

VL - 175

SP - 61-67.e4

JO - Journal of Pediatrics

JF - Journal of Pediatrics

ER -

Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

Abstract

Keywords

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