Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia
Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia
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DOI：
10.1371/journal.pone.0131976
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发表时间：
2015-07-20
期刊：
影响因子：
3.7
通讯作者：
Hung, Hsiao-Fang
中科院分区：
文献类型：
--
作者：
Chang, Hung-Yang;Sung, Yi-Hsiang;Hung, Hsiao-Fang
背景新生儿体温过低仍然是一个常见的问题，并且与发病率和死亡率的升高有关。然而，入院低温对神经发育的长期影响仍不清楚。本研究试图确定极低出生体重(VLBW)早产儿入院体温过低的短期和长期后果。研究设计这项回顾性研究测量了极低出生体重(VLBW)早产儿入院体温过低的发生率，并比较了三级新生儿重症监护病房的结局。婴儿分为常温组(36.5-37.5℃)、轻度低温组(36.0-36.4℃)、中度低温组(32.0-35.9℃)和重度低温组(<；32℃)。结果我们研究了341名婴儿：79名常温组，100名轻度低温组，162名中度低温组，0名重度低温组。与常温组相比，亚低温组患者的胎龄(28.1wk比29.7wk，P<；.02)和出生体重(1004g比1187g，P<；.001)显著降低。与常温儿相比，中度低温儿1分钟Apgar评分及7分的发生率(63.6%vs.31.6%，P<；.001)、呼吸窘迫综合征(RDS)(58.0%vs.39.2%，P=.006)和死亡率(18.5%vs.5.1%，P=.005)显著升高。在矫正年龄为2岁时，亚低温对神经发育结果没有影响。结论入院体温过低在极低出生体重儿中普遍存在，且与出生体重、胎龄呈负相关。尽管中度低温与较高的RDS和死亡率相关，但在神经发育障碍的多因素原因中，它可能发挥的作用有限。
BackgroundNeonatal hypothermia remains a common problem and is related to elevated morbidities and mortality. However, the long-term neurodevelopmental effects of admission hypothermia are still unknown. This study attempted to determine the short-term and long-term consequences of admission hypothermia in VLBW preterm infants.Study DesignThis retrospective study measured the incidence and compared the outcomes of admission hypothermia in very low birth weight (VLBW) preterm infants in a tertiary-level neonatal intensive care unit. Infants were divided into the following groups: normothermia (36.5-37.5 degrees C), mild hypothermia (36.0-36.4 degrees C), moderate hypothermia (32.0-35.9 degrees C), and severe hypothermia (< 32 degrees C). We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.ResultsWe studied 341 infants: 79 with normothermia, 100 with mild hypothermia, 162 with moderate hypothermia, and 0 with severe hypothermia. Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02) and smaller birth weight (1004 g vs. 1187 g, P < .001) compared to patients in the normothermia group. Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001), respiratory distress syndrome (RDS) (58.0% vs. 39.2%, P = .006), and mortality (18.5% vs. 5.1%, P = .005). Moderate hypothermia did not affect neurodevelopmental outcomes at 2 years' corrected age. Mild hypothermia had no effect on short-term or long-term outcomes.ConclusionsAdmission hypothermia was common in VLBW infants and correlated inversely with birth weight and gestational age. Although moderate hypothermia was associated with higher RDS and mortality rates, it may play a limited role among multifactorial causes of neurodevelopmental impairment.