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Ann Neurol. 2013 Apr;73(4):520-8. doi: 10.1002/ana.23843. Epub 2013 Apr 17.

Elevated temperature and 6- to 7-year outcome of neonatal encephalopathy.

Collaborators (152)

Jobe AH, Caplan MS, Oh W, Leach TM, Hensman AM, Noel L, Watson VE, Walsh MC, Fanaroff AA, Wilson-Costello DE, Bass N, Friedman HG, Newman NS, Siner BS, Schibler K, Donovan EF, Yolton K, Bridges K, Steichen JJ, Alexander B, Grisby C, Mincey HL, Hessling J, Gratton TL, Goldberg RN, Cotten C, Goldstein RF, Gustafson KE, Auten KJ, Foy KA, Fisher KA, Grimes S, Lohmeyer MB, Stoll BJ, Carlton DP, Adams-Chapman I, Jain L, Blackwelder AM, Hale EC, Fritz S, Wright LL, McClure EM, Archer SW, Poindexter BB, Lemons JA, Dusick AM, Appel DD, Bissey J, Herron DE, Miller LC, Richard L, Wilson LD, Poole W, Auman JO, Cunningham M, Hammond J, Hastings BK, Huitema CM, Newman JE, Petrie CM, Schaefer SE, Zaterka-Baxter KM, Van Meurs KP, Hintz SR, Stevenson DK, Ball M, DeAnda ME, Carlo WA, Ambalavanan N, Peralta-Carcelen M, Nelson KG, Collins MV, Cosby SS, Phillips VA, Smith LL, Vaucher YE, Fuller MG, West R, Finer NN, Kaegi D, Rasmussen MR, Arnell K, Henderson C, Rich W, Duara S, Bauer CR, Hiriart-Fajardo S, Allison M, Calejo M, Everett-Thomas SR, Eguaras SM, Gauthier S, Papile LA, Lacy CB, Phelps DL, Myers GJ, Guillet R, Hust D, Reubens LJ, Sánchez PJ, Broyles R, Laptook AR, Rosenfeld CR, Salhab WA, Heyne RJ, Boatman C, Dooley C, Hensley G, Hickman JF, Leps MH, Madison S, Miller NA, Morgan JS, Torres LE, Guzman A, Tyson JE, Kennedy KA, Akpa EG, Cluff PA, Franco CI, Lis AE, McDavid GE, Tate PL, Alaniz NI, Bradt PJ, Cedillo M, Dieterich S, Evans PW, Green C, Jiminez M, Major-Kincade T, Morris BH, Poundstone M, Reddoch S, Simmons MC, Whitely LL, Wright SL, Valdés LM, Pappas A, Johnson YR, Goldston LA, Bara R, Muran G, Kennedy D, Pruitt PJ, Ehrenkranz RA, Gettner P, Konstantino M, Poulsen J, Romano E, Williams J, DeLancy S.

Author information

1
Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island, Providence, RI.

Abstract

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.

PMID:
23595408
PMCID:
PMC3720800
DOI:
10.1002/ana.23843
[Indexed for MEDLINE]
Free PMC Article

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