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). INTERPRETATION: 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.
RCT Entities:
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). INTERPRETATION: 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: Jerome Y Yager; Edward A Armstrong; Cleo Jaharus; Deborah M Saucier; Elaine C Wirrell Journal: Brain Res Date: 2004-06-11 Impact factor: 3.252
Authors: Yvonne W Wu; Gabriel J Escobar; Judith K Grether; Lisa A Croen; John D Greene; Thomas B Newman Journal: JAMA Date: 2003-11-26 Impact factor: 56.272
Authors: J Reith; H S Jørgensen; P M Pedersen; H Nakayama; H O Raaschou; L L Jeppesen; T S Olsen Journal: Lancet Date: 1996-02-17 Impact factor: 79.321
Authors: Thomas Wood; Catherine Hobbs; Mari Falck; Anne Charlotte Brun; Else Marit Løberg; Marianne Thoresen Journal: Pediatr Res Date: 2017-11-01 Impact factor: 3.756
Authors: Abbot R Laptook; Seetha Shankaran; Jon E Tyson; Breda Munoz; Edward F Bell; Ronald N Goldberg; Nehal A Parikh; Namasivayam Ambalavanan; Claudia Pedroza; Athina Pappas; Abhik Das; Aasma S Chaudhary; Richard A Ehrenkranz; Angelita M Hensman; Krisa P Van Meurs; Lina F Chalak; Amir M Khan; Shannon E G Hamrick; Gregory M Sokol; Michele C Walsh; Brenda B Poindexter; Roger G Faix; Kristi L Watterberg; Ivan D Frantz; Ronnie Guillet; Uday Devaskar; William E Truog; Valerie Y Chock; Myra H Wyckoff; Elisabeth C McGowan; David P Carlton; Heidi M Harmon; Jane E Brumbaugh; C Michael Cotten; Pablo J Sánchez; Anna Maria Hibbs; Rosemary D Higgins Journal: JAMA Date: 2017-10-24 Impact factor: 56.272
Authors: Emily A O'Brien; Tarah T Colaizy; Jane E Brumbaugh; Gretchen A Cress; Karen J Johnson; Jonathan M Klein; Edward F Bell Journal: J Matern Fetal Neonatal Med Date: 2018-03-07