scholarly journals Hypothermia and neonatal morbimortality in very low birth weight preterm infants

2022 ◽  
Vol 40 ◽  
Author(s):  
Rafaelle Cristine Oliveira Cordeiro ◽  
Daniela Marques de Lima Mota Ferreira ◽  
Heloísio dos Reis ◽  
Vivian Mara Gonçalves de Oliveira Azevedo ◽  
Airan dos Santos Protázio ◽  
...  

ABSTRACT Objective: To assess the prevalence of hypothermia in the delivery room, at admission, and 2 to 3 hours after admission in the neonatal intensive care unit (NICU), factors associated and possible relationship with morbidity and mortality in preterm infants with very low birth weight (VLBW). Methods: Cross-sectional study with data collection based on a retrospective review of medical records and including infants born in 2016 and 2017, with birth weights <1500g, and gestational ages <34 weeks. Data about VLBW preterm infants, maternal data and temperature in the delivery room were analyzed. Hypothermia was considered when axillary temperature <36°C. For statistical analysis, the chi-square test or G test, canonical and Spearman correlation, and logistic regression were used. Results: 149 newborns (NB) were included in the study. The prevalence of hypothermia in delivery room, at admission to the NICU and 2 to 3 hours after admission was 25.8%, 41.5% and 40.2%, respectively. The temperature of NBs was directly proportional to gestational age (p<0.010), birth weight (p<0.010), and Apgar score (p<0.050). There was an inverse association with hypothermia in the delivery room and cesarean delivery (OR 0.25; p=0.016). Conclusions: Hypothermia was a prevalent problem in the studied population. The neonatal temperature was directly proportional to gestational age, birth weight and Apgar score. Hypothermia was associated with maternal factors, such as cesarean delivery. It is necessary to implement and improve strategies for its prevention.

2019 ◽  
Author(s):  
Yong-hui Yu ◽  
Li Wang ◽  
Xiao-yu Dong ◽  
Wen Li ◽  
Lei Huang ◽  
...  

Abstract Background Neonatal hypothermia, defined as a temperature < 36.5°C, is a major contributor to neonatal mortality and morbidity. Hypothermia in preterm infants remains a challenge in the neonatal intensive care unit (NICU) for many reasons.Objective To investigate the incidence of admission hypothermia (AH) in very low-birth weight (VLBW) infants in multiple NICUs in Shandong Province, China, and to provide clinical evidence for the implementation of quality improvement practices to reduce the incidence of AH in NICU.Methods This retrospective, observational study was carried out over a period of 12 months, from January 1, 2018 to December 31, 2018. The correlations between hypothermia preventive measures and the incidence of AH were analysed by descriptive statistical methods and a Spearman analysis. The associations between AH and maternal and neonatal variables were tested with bivariate analyses, followed by stepwise logistic regression. P <0.05 was considered statistically significant.Results A total of 1639 in-born infants who were born at a weight less than 1500 g were enrolled in the study on their day of birth. Among them, 1295 VLBW infants fulfilled the inclusion criteria. The incidence of AH was 87.9% in VLBW infants among the 28 NICUs. We investigated whether team training and education, such as monthly chart reporting on hypothermia in preterm infants on admission to the NICU, which was associated with 10.7% of all the cases, could decrease the rate of AH. Indeed, transport with a heated transport incubator was associated with 9.3% of the cases. here was a negative correlation between the incidence of AH and the number of quality improvement measures implemented to prevent hypothermia (r= -0.242, p <0.05). A low birth weight, intubation in the delivery room , and a low 5-min Apgar score were significantly associated with AH. Conclusion: The incidence of AH was high. There was a negative correlation between the incidence of AH and the number of quality improvement measures implemented to prevent hypothermia. It is important to monitor for AH in newborns who have a low birth weight, who have a low Apgar score at 5 min and who require intubation in the delivery room.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajia Jing ◽  
Yiheng Dai ◽  
Yanqi Li ◽  
Ping Zhou ◽  
Xiaodong Li ◽  
...  

Abstract Background Antenatal corticosteroids (ACS) treatment is critical to support survival and lung maturation in preterm infants, however, its effect on feeding and growth is unclear. Prior preterm delivery, it remains uncertain whether ACS treatment should be continued if possible (repeated course ACS), until a certain gestational age is reached. We hypothesized that the association of single-course ACS with feeding competence and postnatal growth outcomes might be different from that of repeated course ACS in very-low-birth-weight preterm infants. Methods A multicenter retrospective cohort study was conducted in very-low-birth-weight preterm infants born at 23–37 weeks’ gestation in South China from 2011 to 2014. Data on growth, nutritional and clinical outcomes were collected. Repeated course ACS was defined in this study as two or more courses ACS (more than single-course). Infants were stratified by gestational age (GA), including GA < 28 weeks, 28 weeks ≤ GA < 32 weeks and 32 weeks ≤ GA < 37 weeks. Multiple linear regression and multilevel model were applied to analyze the association of ACS with feeding and growth outcomes. Results A total of 841 infants were recruited. The results, just in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation, showed both single and repeated course of ACS regimens had shorter intubated ventilation time compared to non-ACS regimen. Single-course ACS promoted the earlier application of amino acid and enteral nutrition, and higher rate of weight increase (15.71; 95%CI 5.54–25.88) than non-ACS after adjusting for potential confounding factors. No associations of repeated course ACS with feeding, mean weight and weight increase rate were observed. Conclusions Single-course ACS was positively related to feeding and growth outcomes in very-low-birth-weight preterm infants born at 28–32 weeks’ gestation. However, the similar phenomenon was not observed in the repeated course of ACS regimen.


2021 ◽  
Author(s):  
Baoquan Zhang ◽  
Xiujuan Chen ◽  
Changyi Yang ◽  
Huiying Shi ◽  
Wenlong Xiu ◽  
...  

Abstract Purpose This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the mortality and complications in very low birth weight neonates. Methods Premature infants at a gestational age of < 37 weeks with a birth weight of < 1,500g were included in this retrospective analysis. Gestational age-matched pregnant women with normal blood pressure giving birth to a very low birth weight neonate served as normal control. HDP neonates were divided into three subgroups based on the disease severity, including gestational hypertension, pre-eclampsia and eclampsia. Then we compared the incidence of complications among three subgroups. We also analyzed the relationship between the subgroups and the neonatal prognosis. Results The incidence of fetal distress, small for gestational age (SGA), mechanical ventilation, neonatal respiratory distress syndrome (RDS), neonatal necrotizing enterocolitis (NEC, ≥ 2 stage), and mortality in HDP group were significantly higher than those of the control. The 1 min Apgar score in HDP group was significantly lower than that of the normal control (P < 0.05). There were significant differences in fetal distress, 1 min Apgar score, mechanical ventilation, RDS and NEC (≥ 2 stage) among HDP, pre-eclampsia and eclampsia subgroups (P < 0.05). Multivariate regression analysis indicated that pre-eclampsia was an independent risk factor for SGA (OR = 4.123, 95%CI: 2.783–6.109) and NEC (OR = 2.493, 95%CI: 1.161–5.351). Eclampsia was a risk factor for SGA (OR = 3.804, 95%CI: 1.239–11.681) and NEC (OR = 7.264, 95%CI: 1.771–29.797). Conclusions HDP may affect the prognosis of very low birth weight neonates. Pre-eclampsia and eclampsia were risk factors for SGA and NEC.


Author(s):  
Tuba Ozdemir ◽  
Abdullah Baris Akcan ◽  
Munevver Kaynak Turkmen

<p>OBJECTIVE: In the present study, we investigate the growth characteristics of very low birth weight premature infants of up to two years corrected age, considering the factors affecting growth and catch-up growth time.</p><p>STUDY DESIGN: The demographic data, clinical features, and comorbidities of 77 preterm infants with birth weights of less than or equal to 1.500 g were examined, the infants’ growth statuses in the 40th gestational week (gw) and at 6, 12, 18 and 24 months the corrected age, including their weight, height and head circumference, were evaluated.</p><p>RESULTS: The findings revealed that very low birth weight infants should be closely monitored either during their stay in the Neonatal Intensive Care Unit, or for up to 6 months corrected age, paying particular attention to growth data, and the appropriate supportive treatment should be administered. The applied support process is influential on the future somatic growth of preterm infants. It was noted in the study that bronchopulmonary dysplasia, proven sepsis, respiratory distress syndrome, steroid treatment for more than three days, patent ductus arteriosus, and ibuprofen treatment seemed to affect somatic growth negatively.</p><p>CONCLUSION: Small for gestational age newborns were found to catch up with appropriate for gestational age newborns at 2 years corrected age in terms of growth, although the percentage of catch-up growth during follow-up at the 40thgw, and at the 6th, 12th and 18th months was lower than that of appropriate for gestational age newborns.</p>


2017 ◽  
Vol 37 (9) ◽  
pp. 1010-1016 ◽  
Author(s):  
S Arnon ◽  
◽  
T Dolfin ◽  
B Reichman ◽  
R H Regev ◽  
...  

Author(s):  
F. Al Hazzani ◽  
S. Al-Alaiyan ◽  
A. Kattan ◽  
A. Binmanee ◽  
M.B. Jabr ◽  
...  

BACKGROUND: Knowledge on short-term outcomes of preterm infants is important for quality control. Our objective was to analyze the outcomes of very low birth weight infants admitted to our neonatal intensive care unit over a ten years’ period and to compare the results with internationally published data. METHODS: We analyzed the outcome measures for all live born infants with birth weight (BW) of 400–1500 grams and gestational age (GA) of 23–32 weeks born at King Faisal Specialist Hospital & Research Centre between 2006 and 2015. Results were compared to data from three international neonatal networks. RESULTS: During the study period, we admitted 528 infants born at a gestational age of≥23 and≤32 weeks with a very low birth weight (VLBW) of 400–1500 grams. Mean (SD) GA was 28 (2.4) weeks and mean (SD) BW was 1007 (290) grams. A hundred and twenty-nine (24.4%) infants were small for gestational age and major congenital anomalies were present in 56 (10.6 %) infants. The rate of bronchopulmonary dysplasia (BPD) was 24.4 %, necrotizing enterocolitis (NEC) 9.1%, patent ductus arteriosus (PDA) 29.9%, severe intraventricular hemorrhage (IVH)10.8 %, periventricular leukomalacia (PVL) 5.7%, severe retinopathy of prematurity (ROP) 8%, and late-onset sepsis was 18.8%. The incidences of major neonatal outcomes such as CLD, NEC, severe IVH and severe ROP were comparable to the international cohorts. CONCLUSION: In our population of preterm infants, survival rates and complications of prematurity were comparable to international data.


PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 797-801
Author(s):  
Alistair G. S. Philip ◽  
Walter C. Allan ◽  
Alison M. Tito ◽  
Louise R. Wheeler

Ultrasound has been routinely used since late 1979 to diagnose periventricular-intraventricular hemorrhage in infants whose gestational age was 34 weeks or less. During the years 1980 to 1987 the ultrasound scans were interpreted by one person, and a steady decline in incidence of periventricular-intraventricular hemorrhage was observed. Both for infants of 34 weeks or less and for very low birth weight (&lt;1500 g) infants, periventricular-intraventricular hemorrhage incidence decreased, respectively, from 34% and 39% in 1980 to 1981 to 19% and 25% in 1986 to 1987. This decrease was confined to true intraventricular hemorrhages, which decreased from 22% in 1980 to 1981 to 7% in 1986 to 1987 for infants of ≤34 weeks' gestation. These results were not influenced by a change in the distribution of birth weights or gestational ages of the infants evaluated nor by a change in the inborn to outborn ratio. The incidence of periventricular-intraventricular hemorrhage was lower in infants born by cesarean section than those delivered vaginally, but the decrease could not be attributed to an increased number of deliveries by cesarean section. Although there were undoubtedly changes in neonatal care during this time period, no planned intervention occurred. It was concluded that pharmacologic intervention studies must be interpreted with caution.


Sign in / Sign up

Export Citation Format

Share Document