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Negative Temperature Differential in Preterm Infants Less Than 29 Weeks Gestational Age: Associations With Infection
Robin B Knobel-Dail1, Richard Sloane, Diane Holditch-Davis
1Robin B. Knobel-Dail, PhD, RN, FAAN, is Professor and Associate Dean for Faculty Affairs, College of Nursing, University of South Carolina, Columbia. At the time this research was completed, she was Associate Professor, Duke University School of Nursing and Duke University School of Medicine, Durham, North Carolina. Richard Sloane, MPH, is Biostatistician and Senior Staff, Duke University Center for the Study of Aging and Human Development, Durham, North Carolina. Diane Holditch-Davis, PhD, RN, FAAN, is Professor Emeritus, Duke University School of Nursing, Durham, North Carolina. David T. Tanaka, MD, is Professor, Department of Pediatrics and Neonatology, Duke University School of Medicine, Durham, North Carolina.
Background:
Hypothermia is related to increased morbidity and mortality in very preterm infants; continuous temperature monitoring is necessary. Thermoregulation is limited in preterm infants.
Objectives:
The purpose of the research was to assess and describe negative temperature differential (NTD) and assess the associations of NTD with infant demographic characteristics, medical history, and clinical events.
Methods:
An exploratory, case study design was used. Abdominal and foot temperature was measured every minute over the first 2 weeks of life in 22 preterm infants at less than 29 weeks gestational age.
Results:
All infants experienced NTD. Daily NTD in all infants across all study days ranged from 0 to 70.7%; 2-week mean NTD over all infants ranged from 7.3% to 38.5%. Four infants treated for late onset of infection had a higher NTD than 18 infants without infection (M = 27.8%, SD = 9.52 vs. M = 16.4%, SD = 5.34, p < .05). Although not statistically significant, higher mean percentage of NTD was noted in infants having early onset infection (24.1% vs. 16.4%), African American race (20.0% vs. 15.3%), and/or being born to a mother who smoked during pregnancy (26.6% vs. 16.7%).
Discussion:
A larger study is needed to examine associations between NTD and race, maternal smoking history, and infection. NTD might be used as a biomarker to guide acute clinical care and identify infants at risk for acute and chronic morbidity.
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