Admission hypothermia, neonatal morbidity, and mortality: evaluation of a multicenter cohort of very low birth weight preterm infants according to relative performance of the center.

Autor: de Siqueira Caldas JP; Department of Pediatrics, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, Brazil. jamil_pedro@uol.com.br.; Campinas, Brazil. jamil_pedro@uol.com.br., Ferri WAG; Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil., Marba STM; Department of Pediatrics, Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, Brazil.; São Paulo, Brazil., Aragon DC; Department of Pediatrics, Faculdade de Medicina de Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, São Paulo, 14049-900, Brazil., Guinsburg R; São Paulo, Brazil.; Division of Neonatal Medicine, Federal University of São Paulo, São Paulo, Brazil., de Almeida MFB; São Paulo, Brazil.; Division of Neonatal Medicine, Federal University of São Paulo, São Paulo, Brazil., Diniz EMA; Department of Pediatrics, University of São Paulo, School of Medicine, São Paulo, Brazil.; Instituto da Criança, Av Dr. Enéas de Carvalho Aguiar, 647, Pinheiros, São Paulo, São Paulo, 05403-000, Brazil., Silveira RCS; Division of Neonatology, Universidade Federal do Rio Grande do Sul/Hospital de Clínicas de Porto Alegre -HCPA, Rua Silva Jardim 1155/701, Porto Alegre, Rio Grande do Sul, 90450071, Brazil., Alves Junior JMS; Department of Pediatrics, Maternidade Hilda Brandão - Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.; Belo Horizonte, Brazil., Pavanelli MB; São Paulo, Brazil.; Neonatal Unit, Hospital Geral de Pirajussara, Taboão da Serra, Brazil., Bentlin MR; São Paulo, Brazil.; Division of Neonatology, Faculdade de Medicina de Botucatu da, Universidade Estadual Paulista, Botucatu, Brazil., Ferreira DMLM; Department of Pediatrics, Universidade Federal de Uberlândia, Uberlândia, Brazil.; Uberlândia, Brazil., Vale MS; Department of Pediatrics, Universidade Federal do Maranhão, São Luís, Brazil.; São Luís, Brazil., Fiori HH; Department of Pediatrics, Hospital São Lucas - Faculdade de Medicina da, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.; Porto Alegre, Brazil., Duarte JLMB; Department of Pediatrics, Hospital Universitário Pedro Ernesto - Universidade do Estado de Rio de Janeiro, Rio de Janeiro, Brazil.; Rio de Janeiro, Brazil., Meneses JA; Department of Pediatrics, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.; Recife, Brazil., Cwajg S; Rio de Janeiro, Brazil.; Division of Neonatology, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil., Carvalho WB; Department of Pediatrics, University of São Paulo, School of Medicine, São Paulo, Brazil.; Instituto da Criança, Av Dr. Enéas de Carvalho Aguiar, 647, Pinheiros, São Paulo, São Paulo, 05403-000, Brazil., Ferrari LSL; Department of Pediatrics, Hospital Universitário - Universidade Estadual de Londrina, Curitiba, Brazil.; Londrina, Brazil., Silva NMM; Neonatal Unit, Hospital Estadual de Diadema, Diadema, Brazil.; Diadema, Brazil., da Silva RPGVC; Department of Pediatrics, Hospital de Clínicas - Universidade Federal do Paraná, Curitiba, Brazil.; Curitiba, Brazil., Anchieta LM; Division of Neonatology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.; Belo Horizonte, Brazil., Santos JPF; Neonatal Division, Hospital Estadual Sumaré, Sumaré, Brazil.; Sumaré, Brazil., Kawakami MD; Division of Neonatal Medicine, Federal University of São Paulo, São Paulo, Brazil.; Atibaia, Brazil.
Jazyk: angličtina
Zdroj: European journal of pediatrics [Eur J Pediatr] 2019 Jul; Vol. 178 (7), pp. 1023-1032. Date of Electronic Publication: 2019 May 06.
DOI: 10.1007/s00431-019-03386-9
Abstrakt: This prospective cohort study aimed to assess the association of admission hypothermia (AH) with death and/or major neonatal morbidities among very low birth weight (VLBW) preterm infants based on the relative performance of 20 centers of the Brazilian Network of Neonatal Research. This is a retrospective analysis of prospectively collected data using the database registry of the Brazilian Network on Neonatal Research. Center performance was defined by the relative mortality rate using conditional inference trees. A total of 4356 inborn singleton VLBW preterm infants born between January 2013 and December 2016 without malformations were included in this study. The centers were divided into two groups: G1 (with lower mortality rate) and G2 (with higher mortality rate). Crude and adjusted relative risks (RR) and 95% confidence intervals (95%CI) were estimated by simple and multiple log-binomial regression models. An AH rate of 53.7% (19.8-93.3%) was significantly associated with early neonatal death in G1 (adjusted RR 1.41, 95% CI 1.09-1.84) and G2 (adjusted RR 1.29, 95%CI 1.01-1.65) and with in-hospital death in G1 (adjusted RR 1.29, 95%CI 1.07-1.58). AH was significantly associated with a lower frequency of necrotizing enterocolitis (adjusted RR 0.58, 95%CI 38-0.88) in G2.Conclusion: AH significantly associated with early neonatal death regardless of the hospital performance. In G2, an unexpected protective association between AH and necrotizing enterocolitis was found, whereas the other morbidities assessed were not significantly associated with AH. What is Known: • Admission hypothermia is associated with early neonatal death. • The association of admission hypothermia with major neonatal morbidities has not been fully established. What is New: • Admission hypothermia was significantly associated with early neonatal and in-hospital death in centers with the lowest relative mortality rates. • Admission hypothermia was not associated with major neonatal morbidities and with in-hospital death but was found to be a protective factor against necrotizing colitis in centers with the highest relative mortality rates.
Databáze: MEDLINE
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