Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/201650
Type: Artigo de periódico
Title: Hypothermia And Early Neonatal Mortality In Preterm Infants.
Author: de Almeida, Maria Fernanda Branco
Guinsburg, Ruth
Sancho, Guilherme Assis
Rosa, Izilda Rodrigues Machado
Lamy, Zeni Carvalho
Martinez, Francisco Eulógio
da Silva, Regina Paula Guimarães Vieira Cavalcante
Ferrari, Lígia Silvana Lopes
de Souza Rugolo, Ligia Maria Suppo
Abdallah, Vânia Olivetti Steffen
Silveira, Rita de Cássia
,
Abstract: To evaluate intervention practices associated with hypothermia at both 5 minutes after birth and at neonatal intensive care unit (NICU) admission and to determine whether hypothermia at NICU admission is associated with early neonatal death in preterm infants. This prospective cohort included 1764 inborn neonates of 22-33 weeks without malformations admitted to 9 university NICUs from August 2010 through April 2012. All centers followed neonatal International Liaison Committee on Resuscitation recommendations for the stabilization and resuscitation in the delivery room (DR). Variables associated with hypothermia (axillary temperature <36.0 °C) 5 minutes after birth and at NICU admission, as well as those associated with early death, were analyzed by logistic regression. Hypothermia 5 minutes after birth and at NICU admission was noted in 44% and 51%, respectively, with 6% of early neonatal deaths. Adjusted for confounding variables, practices associated with hypothermia at 5 minutes after birth were DR temperature <25 °C (OR 2.13, 95% CI 1.67-2.28), maternal temperature at delivery <36.0 °C (OR 1.93, 95% CI 1.49-2.51), and use of plastic bag/wrap (OR 0.53, 95% CI 0.40-0.70). The variables associated with hypothermia at NICU admission were DR temperature <25 °C (OR 1.44, 95% CI 1.10-1.88), respiratory support with cold air in the DR (OR 1.40, 95% CI 1.03-1.88) and during transport to NICU (OR 1.51, 95% CI 1.08-2.13), and cap use (OR 0.55, 95% CI 0.39-0.78). Hypothermia at NICU admission increased the chance of early neonatal death by 1.64-fold (95% CI 1.03-2.61). Simple interventions, such as maintaining DR temperature >25 °C, reducing maternal hypothermia prior to delivery, providing plastic bags/wraps and caps for the newly born infants, and using warm resuscitation gases, may decrease hypothermia at NICU admission and improve early neonatal survival.
Subject: Brazil
Female
Follow-up Studies
Gestational Age
Humans
Hypothermia
Infant Mortality
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
Intensive Care Units, Neonatal
Male
Prognosis
Prospective Studies
Survival Rate
Dr
Delivery Room
Nicu
Neonatal Intensive Care Unit
Vlbw
Very Low Birth Weight
Rights: fechado
Identifier DOI: 10.1016/j.jpeds.2013.09.049
Address: http://www.ncbi.nlm.nih.gov/pubmed/24210925
Date Issue: 2014
Appears in Collections:Artigos e Materiais de Revistas Científicas - Unicamp

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