[P2-136] Effect of Elevated Temperature on Immediate Neurodevelopmental Outcome in Term Neonates with Hypoxic-ischemic encephalopathy
[Background] Among term infants, hypoxic–ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood. Treatment is currently limited to supportive intensive care, without any specific brain-oriented therapy.
[Objective] To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature occurring between 12 and 72 hours of birth.
[Methods] This was an prospective observational study. Asphyxiated newborns who came within 12 hours of birth was enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours. Outcomes were related to temperatures in logistic regression analyses for the elevated/relatively high temperatures and normal/low temperatures group, with adjustment of the level of encephalopathy and gender.
[Results] The mean axillary temperature was 36.07 ± 6.10C and 25.71%, 11.92% and 6.32% of all axillary temperatures were >370C, >37.50C and >380C respectively. The mean rectal temperature was 36.8 ± 60C, and 43.53%, 30.02% and 19.97% of all rectal temperatures were >370C, >37.50C and >380C respectively. There was significant correlation between axillary and rectal temperature (r= 0.889). For elevated temperature, the odds of death or moderate to severe impairment was increased 8.9 fold (Cl 0.906 – 88.18 ) and the odds of death alone was increased 4.6 fold (Cl 0.373 – 56.83). The odds of impairment was increased 1.84 fold (Cl 0.45 – 7.50) .
[Conclusion] Relatively high temperature during usual care after hypoxic-ischemia in term neonates were associated with adverse neurodevelopmental outcomes.
[Objective] To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature occurring between 12 and 72 hours of birth.
[Methods] This was an prospective observational study. Asphyxiated newborns who came within 12 hours of birth was enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours. Outcomes were related to temperatures in logistic regression analyses for the elevated/relatively high temperatures and normal/low temperatures group, with adjustment of the level of encephalopathy and gender.
[Results] The mean axillary temperature was 36.07 ± 6.10C and 25.71%, 11.92% and 6.32% of all axillary temperatures were >370C, >37.50C and >380C respectively. The mean rectal temperature was 36.8 ± 60C, and 43.53%, 30.02% and 19.97% of all rectal temperatures were >370C, >37.50C and >380C respectively. There was significant correlation between axillary and rectal temperature (r= 0.889). For elevated temperature, the odds of death or moderate to severe impairment was increased 8.9 fold (Cl 0.906 – 88.18 ) and the odds of death alone was increased 4.6 fold (Cl 0.373 – 56.83). The odds of impairment was increased 1.84 fold (Cl 0.45 – 7.50) .
[Conclusion] Relatively high temperature during usual care after hypoxic-ischemia in term neonates were associated with adverse neurodevelopmental outcomes.