title: Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity.
abstract: To investigate the association between body temperature at admission to neonatal intensive care and in-hospital mortality in very preterm infants, stratified by postnatal age of death. Moreover, we assessed the association between admission temperature and neonatal morbidity.
  
  
  
  In this cohort study from 19 regions in 11 European countries, we measured body temperature at admission for infants admitted for neonatal care after very preterm birth (<32 weeks of gestation; n = 5697) who were followed to discharge or death. Associations between body temperature at admission and in-hospital mortality and neonatal morbidity were analyzed by the use of mixed effects generalized linear models. The final model adjusted for pregnancy complications, singleton or multiple pregnancy, antenatal corticosteroids, mode of delivery, gestational age, infant size and sex, and Apgar score <7 at 5 minutes.
  
  
  
  A total of 53.4% of the cohort had a body temperature at admission less than 36.5°C, and 12.9% below 35.5°C. In the adjusted model, an admission temperature <35.5°C was associated with increased mortality at postnatal ages 1-6 days, (risk ratio 2.41; 95% CI 1.45-4.00), and 7-28 days (risk ratio 1.79; 1.15-2.78) but not after 28 days of age. We found no associations between admission temperature and neonatal morbidity.
  
  
  
  Admission hypothermia after very preterm birth is a significant problem in Europe, associated with an increased risk of early and late neonatal death.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Gynecology and Obstetrics, Danderyd University Hospital, Stockholm, Sweden. Electronic address: emilija.wilson@ki.se.
authors.forename: Emilija
authors.initials: E
authors.lastname: Wilson
authors.affiliation: Children's Hospital, Philipps University, Marburg, Germany.
authors.forename: Rolf F
authors.initials: RF
authors.lastname: Maier
authors.affiliation: Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Norman
authors.affiliation: Institute of Quality Assurance Hesse, Eschborn, Germany.
authors.forename: Bjoern
authors.initials: B
authors.lastname: Misselwitz
authors.affiliation: Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Howell
authors.affiliation: Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, Paris, France; DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Zeitlin
authors.affiliation: Department of Women's and Children's Health and Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Sachs' Children and Youth Hospital, Stockholm, Sweden.
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Bonamy
mesh_terms: D001831:Body Temperature; D005060:Europe / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007035:Hypothermia / Q000453:epidemiology / Q000401:mortality*; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000401:mortality*; D007363:Intensive Care Units, Neonatal; D016014:Linear Models; D008297:Male; D010343:Patient Admission; D011446:Prospective Studies; D012307:Risk Factors
keywords: epidemiology; neonatal intensive care; very preterm birth