Significant Pathology in Young Infants Presenting With Hypothermia: A Multicenter Study.

Area of Science:

• Pediatrics
• Neonatology
• Emergency Medicine

Background:

• Hypothermia in young infants (≤90 days) is commonly linked to immature thermoregulation.
• However, it can also signal serious, underlying medical conditions requiring prompt diagnosis and management.

Purpose of the Study:

• To determine the prevalence and types of significant pathology in young infants presenting with hypothermia.
• To explore associations between hypothermia and presenting characteristics or evaluation findings.

Main Methods:

• A multicenter, retrospective cohort study was conducted over 5 years.
• Included were infants ≤90 days with documented hypothermia (≤36.0 °C) in the emergency department or upon admission.
• Significant pathology was defined as a diagnosis warranting hospitalization; multivariate logistic regression analyzed associations.

Main Results:

• Of 998 infants, 32% had significant pathology, including 4% with serious infections (bacterial, HSV) and 28% with other significant diagnoses.
• Older age (29-90 days), ill appearance, repeated temperature instability, and abnormal white blood cell counts were significantly associated with pathology.

Conclusions:

• Hypothermia in young infants frequently presents with significant, non-infectious pathologies.
• Clinical decision tools for managing hypothermic infants should consider a broader range of potential diagnoses beyond serious infections.