Admission temperature and neonatal outcomes - single-centre experience in Saudi Arabia

Ammar Fneish; Mohammad Alhasoon; Amenah Al Essa; Radha Mahlangu; Noura Alshami; Saif Alsaif; Kamal Ali

doi:10.1016/j.ijpam.2022.12.001

Admission temperature and neonatal outcomes - single-centre experience in Saudi Arabia

Int J Pediatr Adolesc Med. 2022 Dec;9(4):203-208. doi: 10.1016/j.ijpam.2022.12.001. Epub 2022 Dec 23.

Authors

Ammar Fneish¹, Mohammad Alhasoon², Amenah Al Essa¹, Radha Mahlangu¹, Noura Alshami¹, Saif Alsaif¹, Kamal Ali¹

Affiliations

¹ Neonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia.
² Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia.

Abstract

Objective: This study aimed to investigate the association between admission hypothermia (AH), neonatal mortality and major neonatal morbidities in preterm infants <33 weeks' gestation. An additional aim of the study was to examine changes in the prevalence of admission hypothermia after the initiation of a thermoregulation quality improvement (QI) project.

Method: This is a retrospective cohort study of preterm infants < 33 weeks' gestation born at King AbdulAziz Medical City Riyadh (KAMC-R) between January 2017 to December 2020.

Results: Eight-hundred infants were born during the study period. Four hundred and one infants (50.1%) had an admission temperature of <36.5 °C and a further 399 (49.9%) had an admission temperature of >36.5 °C. The mortality before discharge was 15.7% in infants with AH compared to 4.8% among those with an admission temperature above 36.5 °C. This remained statistically significant after adjustments for gestational age and maternal PET status on a multivariate analysis (P = .001, OR 2.7,95%CI 1.5-4.7). The need for mechanical ventilation (P = .005) and incidence of surgical NEC (P = .030) were significantly different between the two temperature groups. Mean (SD) admission temperature increased from 36.3 °C to 36.6 °C following the thermoregulation intervention program (P <.001). Admission temperature <36 °C is associated with higher mortality in the first week (P = .001, OR 3.3,95% CI (1.7-6.6)) and increased incidence of cystic PVL (P = .04, OR 2.1, CI (1.03-4.3)).

Conclusion: Preterm infants with AH suffered higher mortality and greater neonatal morbidities.

Keywords: AH, Admission hypothermia; BPD, Bronchopulmonary dysplasia; Hypothermia; IVH, Intraventricular haemorrhage; Morbidities; Mortality; NEC, Necrotising enterocolitis; Neonate; PMA, Post menstrual age; PVL, Periventricular leukomalacia; Preterm birth; ROP, Rentinopathy of prematurity.