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Admission Temperature and Associated Mortality and Morbidity among Moderately and Extremely Preterm Infants

Abbot R Laptook1, Edward F Bell2, Seetha Shankaran3

  • 1Department of Pediatrics, Brown University, Providence, RI.

The Journal of Pediatrics
|December 17, 2017
PubMed

Insights

Neonatal intensive care unit (NICU) admission temperatures vary between moderately preterm (MPT) and extremely preterm (EPT) infants. Despite changes in temperature distribution, lower admission temperatures consistently correlate with higher mortality risks for these vulnerable newborns.

Area of Science:

  • Neonatology
  • Perinatal Medicine
  • Pediatric Critical Care

Background:

  • Thermoregulation is critical for preterm infants, impacting outcomes.
  • Admission temperature variations in neonatal intensive care units (NICUs) are a concern for extremely preterm (EPT) and moderately preterm (MPT) infants.
  • Previous data from 2002-2003 indicated significant temperature challenges for EPT infants.

Purpose of the Study:

  • To assess NICU admission temperature distribution in MPT and EPT infants in 2012-2013.
  • To analyze changes in admission temperature distribution for EPT infants from 2002-2003 to 2012-2013.
  • To determine the association between NICU admission temperature and mortality/morbidity in MPT and EPT infants.

Main Methods:

  • Prospective data collection from 18 Neonatal Research Network centers.
  • Analysis of NICU admission temperatures for inborn MPT (29-33 weeks) and EPT (<29 weeks) infants.
  • Multivariable logistic regression to assess associations between temperature and outcomes, comparing EPT infants from two distinct time periods (2002-2003 and 2012-2013).

Main Results:

  • In 2012-2013, admission temperatures differed significantly between MPT and EPT infants.
  • Higher percentages of both low (<36.5°C) and high (>37.5°C) admission temperatures were observed in EPT infants compared to MPT infants.
  • For EPT infants, the proportion with normal temperatures (36.5°C-37.5°C) more than doubled, and hyperthermia (>37.5°C) more than tripled from 2002-2003 to 2012-2013.

Conclusions:

  • Both low and high admission temperatures are more prevalent in EPT infants than MPT infants.
  • While fewer EPT infants experienced hypothermia in 2012-2013 compared to a decade prior, hyperthermia became more common.
  • An inverse relationship between admission temperature and in-hospital mortality risk persists, regardless of changes in temperature distribution.
Abstract

Keywords:
hyperthermiahypothermiaprematuritysurvival

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