Relationship Between Admission Temperature and Risk of Cerebral Palsy in Infants Admitted to Special Care Unit in a Low Resource Setting: A Retrospective Single-Center Study

Overview

Journal Children (Basel)

Specialty Health Services

Date 2022 Mar 25

PMID 35327724

Authors

Chiara Guadagno

Francesco Cavallin

Luca Brasili

Donald Micah Maziku

Dionis Erasto Leluko

Gaetano Azzimonti

Giovanni Putoto

Andrea Pietravalle

Daniele Trevisanuto

Affiliations

Soon will be listed here.

Abstract

Background: Deviations from normothermia affect early mortality and morbidity, but the impact on neurodevelopment of the survivors is unclear. We aimed to investigate the relationship between neonatal temperature at admission and the risk of cerebral palsy (CP) at one month of age in a low-resource setting.

Methods: This retrospective study included all inborn neonates admitted to the Special Care Unit of Tosamaganga Hospital (Tanzania) between 1 January 2019 and 31 December 2020. The neurological examination at one month of age was performed using the Hammersmith method. The relationship between the admission temperature and the risk of CP was investigated using logistic regression models, with temperature modeled as the non-linear term.

Results: High/moderate risk of CP was found in 40/119 (33.6%) of the neonates at one month of age. A non-linear relationship between the admission temperature and moderate/high risk of CP at one month of age was found. The lowest probability of moderate/high risk of CP was estimated at admission temperatures of between 35 and 36 °C, with increasing probability when departing from such temperatures.

Conclusions: In a low-resource setting, we found a U-shaped relationship between the admission temperature and the risk of CP at one month of life. Expanding the analysis of the follow-up data to 12-24 months of age would be desirable in order to confirm and strengthen such findings.

Citing Articles

Factors associated with mortality and neurodevelopmental impairment at 12 months in asphyxiated newborns: a retrospective cohort study in rural Tanzania from January 2019 to June 2022.

Manzini E, Borellini M, Belardi P, Mlawa E, Kadinde E, Mwibuka C BMC Pregnancy Childbirth. 2024; 24(1):660.

PMID: 39390417 PMC: 11468089. DOI: 10.1186/s12884-024-06837-w.

Rewarming rate of hypothermic neonates in a low-resource setting: a retrospective single-center study.

Rossi E, Maziku D, Leluko D, Guadagno C, Brasili L, Azzimonti G Front Pediatr. 2023; 11:1113897.

PMID: 37228438 PMC: 10203202. DOI: 10.3389/fped.2023.1113897.

References

Kasdorf E, Perlman J . Hyperthermia, inflammation, and perinatal brain injury. Pediatr Neurol. 2013; 49(1):8-14. DOI: 10.1016/j.pediatrneurol.2012.12.026. View

KRAMER L . Advancement of dermal icterus in the jaundiced newborn. Am J Dis Child. 1969; 118(3):454-8. DOI: 10.1001/archpedi.1969.02100040456007. View

Miller S, Lee H, Gould J . Hypothermia in very low birth weight infants: distribution, risk factors and outcomes. J Perinatol. 2011; 31 Suppl 1:S49-56. DOI: 10.1038/jp.2010.177. View

Cavallin F, Calgaro S, Brugnolaro V, Wingi O, Muhelo A, Da Dalt L . Non-linear association between admission temperature and neonatal mortality in a low-resource setting. Sci Rep. 2020; 10(1):20800. PMC: 7695844. DOI: 10.1038/s41598-020-77778-5. View

Brown V, Oluwatosin O . Feasibility of implementing a cellphone-based reminder/recall strategy to improve childhood routine immunization in a low-resource setting: a descriptive report. BMC Health Serv Res. 2017; 17(Suppl 2):703. PMC: 5773899. DOI: 10.1186/s12913-017-2639-8. View

Ngeny J, Velaphi S . Hypothermia among neonates admitted to the neonatal unit at a tertiary hospital in South Africa. J Perinatol. 2019; 40(3):433-438. DOI: 10.1038/s41372-019-0539-y. View

Yu Y, Wang L, Huang L, Wang L, Huang X, Fan X . Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study. BMC Pediatr. 2020; 20(1):321. PMC: 7322890. DOI: 10.1186/s12887-020-02221-7. View

Lunze K, Hamer D . Thermal protection of the newborn in resource-limited environments. J Perinatol. 2012; 32(5):317-24. DOI: 10.1038/jp.2012.11. View

Mullany L . Neonatal hypothermia in low-resource settings. Semin Perinatol. 2010; 34(6):426-33. PMC: 3001630. DOI: 10.1053/j.semperi.2010.09.007. View

10.

Chang H, Sung Y, Wang S, Lung H, Chang J, Hsu C . Short- and Long-Term Outcomes in Very Low Birth Weight Infants with Admission Hypothermia. PLoS One. 2015; 10(7):e0131976. PMC: 4507863. DOI: 10.1371/journal.pone.0131976. View

11.

Wilson E, Maier R, Norman M, Misselwitz B, Howell E, Zeitlin J . Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity. J Pediatr. 2016; 175:61-67.e4. DOI: 10.1016/j.jpeds.2016.04.016. View

12.

Lunze K, Bloom D, Jamison D, Hamer D . The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC Med. 2013; 11:24. PMC: 3606398. DOI: 10.1186/1741-7015-11-24. View

13.

Novak I, Morgan C, Adde L, Blackman J, Boyd R, Brunstrom-Hernandez J . Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatr. 2017; 171(9):897-907. PMC: 9641643. DOI: 10.1001/jamapediatrics.2017.1689. View

14.

Laptook A, Salhab W, Bhaskar B . Admission temperature of low birth weight infants: predictors and associated morbidities. Pediatrics. 2007; 119(3):e643-9. DOI: 10.1542/peds.2006-0943. View

15.

Beletew B, Mengesha A, Wudu M, Abate M . Prevalence of neonatal hypothermia and its associated factors in East Africa: a systematic review and meta-analysis. BMC Pediatr. 2020; 20(1):148. PMC: 7118870. DOI: 10.1186/s12887-020-02024-w. View

16.

Lyu Y, Shah P, Ye X, Warre R, Piedboeuf B, Deshpandey A . Association between admission temperature and mortality and major morbidity in preterm infants born at fewer than 33 weeks' gestation. JAMA Pediatr. 2015; 169(4):e150277. DOI: 10.1001/jamapediatrics.2015.0277. View

17.

Pietravalle A, Scilipoti M, Cavallin F, Lonardi M, Tshikamb I, Robbiati C . Nutritional education during rehabilitation of children 6-24 months with acute malnutrition, under unavailability of therapeutic/supplementary foods: a retrospective study in rural Angola. BMC Pediatr. 2021; 21(1):94. PMC: 7903716. DOI: 10.1186/s12887-021-02560-z. View

18.

Spittle A, Walsh J, Olsen J, Mcinnes E, Eeles A, Brown N . Neurobehaviour and neurological development in the first month after birth for infants born between 32-42 weeks' gestation. Early Hum Dev. 2016; 96:7-14. DOI: 10.1016/j.earlhumdev.2016.02.006. View

19.

Trevisanuto D, Testoni D, de Almeida M . Maintaining normothermia: Why and how?. Semin Fetal Neonatal Med. 2018; 23(5):333-339. DOI: 10.1016/j.siny.2018.03.009. View