title: Macrosomia and haemodynamic instability may represent risk factors for subcutaneous fat necrosis in asphyxiated newborns treated with hypothermia.
abstract: OBJECTIVE
  To identify additional risk factors other than asphyxia and hypothermia in newborns developing subcutaneous fat necrosis (SCFN).
  
  
  METHODS
  We conducted a prospective cohort study of all term asphyxiated newborns treated with hypothermia from 2008 to 2015. The presence and location of SCFN were recorded at the time of discharge or at follow-up visits. To identify the risk factors for developing SCFN, we compared the perinatal characteristics of those newborns who developed SCFN with those who did not.
  
  
  RESULTS
  The newborns developing SCFN had significantly higher birthweights compared with those newborns who did not develop SCFN. Among the newborns with a birthweight equal or superior to the 90th percentile, those who developed SCFN had a significantly higher use of inotropic support and higher maximum troponin levels during their initial hospitalisation.
  
  
  CONCLUSIONS
  A higher birthweight represented an independent risk factor for developing SCFN in asphyxiated newborns treated with hypothermia. When macrosomia is present, other risk factors related to haemodynamic instability during the initial hospitalisation may also increase the risk of developing SCFN.
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, McGill University, Montreal, QC, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Courteau
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, McGill University, Montreal, QC, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Samman
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, QC, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Ali
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, McGill University, Montreal, QC, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Riley
authors.affiliation: Division of Newborn Medicine, Department of Pediatrics, McGill University, Montreal, QC, Canada.
authors.forename: P
authors.identifier: http://orcid.org/0000-0002-7611-6670
authors.initials: P
authors.lastname: Wintermark
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications* / Q000628:therapy; D005218:Fat Necrosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications*; D006439:Hemodynamics; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors
keywords: Birth asphyxia; Neonatal encephalopathy; Subcutaneous fat necrosis