title: Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia.
abstract: BACKGROUND
  Neonatal hypothermia remains a common problem and is related to elevated morbidities and mortality. However, the long-term neurodevelopmental effects of admission hypothermia are still unknown. This study attempted to determine the short-term and long-term consequences of admission hypothermia in VLBW preterm infants.
  
  
  METHODS
  This retrospective study measured the incidence and compared the outcomes of admission hypothermia in very low birth weight (VLBW) preterm infants in a tertiary-level neonatal intensive care unit. Infants were divided into the following groups: normothermia (36.5-37.5°C), mild hypothermia (36.0-36.4°C), moderate hypothermia (32.0-35.9°C), and severe hypothermia (< 32°C). We compared the distribution, demographic variables, short-term outcomes, and neurodevelopmental outcomes at 24 months of corrected age among groups.
  
  
  RESULTS
  We studied 341 infants: 79 with normothermia, 100 with mild hypothermia, 162 with moderate hypothermia, and 0 with severe hypothermia. Patients in the moderate hypothermia group had significantly lower gestational ages (28.1 wk vs. 29.7 wk, P < .02) and smaller birth weight (1004 g vs. 1187 g, P < .001) compared to patients in the normothermia group. Compared to normothermic infants, moderately hypothermic infants had significantly higher incidences of 1-min Apgar score < 7 (63.6% vs. 31.6%, P < .001), respiratory distress syndrome (RDS) (58.0% vs. 39.2%, P = .006), and mortality (18.5% vs. 5.1%, P = .005). Moderate hypothermia did not affect neurodevelopmental outcomes at 2 years' corrected age. Mild hypothermia had no effect on short-term or long-term outcomes.
  
  
  CONCLUSIONS
  Admission hypothermia was common in VLBW infants and correlated inversely with birth weight and gestational age. Although moderate hypothermia was associated with higher RDS and mortality rates, it may play a limited role among multifactorial causes of neurodevelopmental impairment.
authors.affiliation: Department of Pediatrics, MacKay Memorial Hospital, Hsinchu Branch, Hsinchu, Taiwan; Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
authors.forename: Hung-Yang
authors.initials: HY
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, MacKay Memorial Hospital, Hsinchu Branch, Hsinchu, Taiwan.
authors.forename: Yi-Hsiang
authors.initials: YH
authors.lastname: Sung
authors.affiliation: Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.
authors.forename: Shwu-Meei
authors.initials: SM
authors.lastname: Wang
authors.affiliation: Department of Pediatrics, MacKay Memorial Hospital, Hsinchu Branch, Hsinchu, Taiwan.
authors.forename: Hou-Ling
authors.initials: HL
authors.lastname: Lung
authors.affiliation: Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.
authors.forename: Jui-Hsing
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.
authors.forename: Chyong-Hsin
authors.initials: CH
authors.lastname: Hsu
authors.affiliation: Department of Pediatrics, MacKay Children's Hospital, Taipei, Taiwan.
authors.forename: Wai-Tim
authors.initials: WT
authors.lastname: Jim
authors.affiliation: Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
authors.forename: Ching-Hsiao
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
authors.forename: Hsiao-Fang
authors.initials: HF
authors.lastname: Hung
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D010343:Patient Admission; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors