title: Elevated temperature and 6- to 7-year outcome of neonatal encephalopathy.
abstract: OBJECTIVE
  A study was undertaken to determine whether higher temperature after hypoxia-ischemia is associated with death or intelligence quotient (IQ)<70 at 6 to 7 years among infants treated with intensive care without hypothermia.
  
  
  METHODS
  Control infants (noncooled, n=106) of the National Institute of Child Health and Human Development Neonatal Research Network hypothermia trial had serial esophageal and skin temperatures over 72 hours. Each infant's temperature was ranked to derive an average of the upper and lower quartile, and median of each site. Temperatures were used in logistic regressions to determine adjusted associations with death or IQ<70 at 6 to 7 years. Secondary outcomes were death, IQ<70, and moderate/severe cerebral palsy (CP). IQ and motor function were assessed with Wechsler Scales for Children and Gross Motor Function Classification System. Results are odds ratio (OR; per degree Celsius increment within the quartile or median) and 95% confidence interval (CI).
  
  
  RESULTS
  Primary outcome was available for 89 infants. At 6 to 7 years, death or IQ<70 occurred in 54 infants (37 deaths, 17 survivors with IQ<70) and moderate/severe CP in 15 infants. Death or IQ<70 was associated with the upper quartile average of esophageal (OR=7.3, 95% CI=2.0-26.3) and skin temperature (OR=3.5, 95% CI=1.2-10.4). CP was associated with the upper quartile average of esophageal (OR=12.5, 95% CI=1.02-155) and skin temperature (OR=10.3, 95% CI=1.3-80.2).
  
  
  CONCLUSIONS
  Among noncooled infants of a randomized trial, elevated temperatures during the first postnatal days are associated with increased odds of a worse outcome at 6 to 7 years.
authors.affiliation: Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island, Providence, RI.
authors.forename: Abbot R
authors.initials: AR
authors.lastname: Laptook
authors.forename: Scott A
authors.initials: SA
authors.lastname: McDonald
authors.forename: Seetha
authors.initials: S
authors.lastname: Shankaran
authors.forename: Bonnie E
authors.initials: BE
authors.lastname: Stephens
authors.forename: Betty R
authors.initials: BR
authors.lastname: Vohr
authors.forename: Ronnie
authors.initials: R
authors.lastname: Guillet
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
mesh_terms: D000293:Adolescent; D001831:Body Temperature / Q000502:physiology*; D001927:Brain Diseases / Q000150:complications / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019370:Observation; D016896:Treatment Outcome