Outcomes of neonatal hypothermia among very low birth weight infants: a Meta-analysis

Sagad Omer Obeid Mohamed1, Sara Mohamed Ibrahim Ahmed1, Reem Jamal Yousif Khidir1, Mutaz Tarig Hassan Ahmed Shaheen1, Mosab Hussen Mostafa Adam1, Basil Abubakr Yagoub Ibrahim1, Esra Osama Abdelrahman Elmahdi1, Abubaker Shadoul Mohamed Farah1
1Faculty of Medicine, University of Khartoum, Khartoum, Sudan

Tóm tắt

Neonatal admission hypothermia (HT) is a frequently encountered problem in neonatal intensive care units (NICUs) and it has been linked to a higher risk of mortality and morbidity. However, there is a disparity in data in the existing literature regarding the prevalence and outcomes associated with HT in very low birth weight (VLBW) infants. This review aimed to provide further summary and analyses of the association between HT and adverse clinical outcomes in VLBW infants. In July 2020, we conducted this review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic database search was conducted in MEDLINE (PubMed), Google Scholar, ScienceDirect, World Health Organization Virtual Health Library, Cochrane Library databases, and System for Information on Grey Literature in Europe (SIGLE). We included studies that assessed the prevalence of HT and/or the association between HT and any adverse outcomes in VLBW infants. We calculated the pooled prevalence and Odds Ratio (OR) estimates with the corresponding 95% Confidence Interval (CI) using the Comprehensive meta-analysis software version 3.3 (Biostat, Engle-wood, NJ, USA; http://www.Meta-Analysis.com ). Eighteen studies that fulfilled the eligibility criteria were meta-analyzed. The pooled prevalence of HT among VLBW infants was 48.3% (95% CI, 42.0–54.7%). HT in VLBW infants was significantly associated with mortality (OR = 1.89; 1.72–2.09), intra-ventricular hemorrhage (OR = 1.86; 1.09–3.14), bronchopulmonary dysplasia (OR = 1.28; 1.16–1.40), neonatal sepsis (OR = 1.47; 1.09–2.49), and retinopathy of prematurity (OR = 1.45; 1.28–1.72). Neonatal HT rate is high in VLBW infants and it is a risk factor for mortality and morbidity in VLBW infants. This review provides a comprehensive view of the prevalence and outcomes of HT in VLBW infants.

Tài liệu tham khảo

Amadi HO, Olateju EK, Alabi P, Kawuwa MB, Ibadin MO, Osibogun AO. Neonatal hyperthermia and thermal stress in low-and middle-income countries: a hidden cause of death in extremely low-birthweight neonates. Paediatr Int Child Health. 2015;35(3):273–81. https://doi.org/10.1179/2046905515Y.0000000030. Lunze K, Bloom DE, Jamison DT, Hamer DH. The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC Med. 2013;11(1). https://doi.org/10.1186/1741-7015-11-24. Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375(9730):1969–87. https://doi.org/10.1016/S0140-6736(10)60549-1. Bang AT, Reddy HM, Bang RA, Deshmukh MD. Why do neonates die in rural Gadchiroli, India? (Part II): Estimating population attributable risks and contribution of multiple morbidities for identifying a strategy to prevent deaths. J Perinatol. 2005;25 Suppl 1:S35–43. https://doi.org/10.1038/sj.jp.7211270. Yu YH, Wang L, Huang L, Wang LL, Huang XY, Fan XF, et al. Association between admission hypothermia and outcomes in very low birth weight infants in China: a multicentre prospective study. BMC Pediatr. 2020;20:321. https://doi.org/10.1186/s12887-020-02221-7. Miller SS, Lee HC, Gould JB. Hypothermia in very low birth weight infants: Distribution, risk factors and outcomes. J Perinatol. 2011;31 Suppl 1:S49–56. https://doi.org/10.1038/jp.2010.177. Ting JY, Synnes AR, Lee SK, Shah PS. Association of admission temperature and death or adverse neurodevelopmental outcomes in extremely low-gestational age neonates. J Perinatol. 2018;38(7):844–9. https://doi.org/10.1038/s41372-018-0099-6. Feldman A, de Benedictis B, Alpan G, la Gamma EF, Kase J. Morbidity and mortality associated with rewarming hypothermic very low birth weight infants. J Neonatal-Perinatal Med. 2016;9(3):295–302. https://doi.org/10.3233/NPM-16915143. Caldas DSJP, Ferri WAG, Marba STM, Aragon DC, Guinsburg R, de Almeida MFB, et al. 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. Eur J Pediatr. 2019;178(7):1023–32. https://doi.org/10.1007/s00431-019-03386-9. Chang HY, Sung YH, Wang SM, Lung HL, Chang JH, Hsu CH, et al. Short- and long-term outcomes in very low birth weight infants with admission hypothermia. PLoS One. 2015;10(7):e0131976. https://doi.org/10.1371/journal.pone.0131976. Ng’eny JC, Velaphi S. Hypothermia among neonates admitted to the neonatal unit at a tertiary hospital in South Africa. J Perinatol. 2020;40(3):433–8. https://doi.org/10.1038/s41372-019-0539-y. Guinsburg R, de Almeida MFB, de Castro JS, Silveira RC, Caldas JPDS, Fiori HH, et al. Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers. J Matern Fetal Neonatal Med. 2016;29(6):1005–9. https://doi.org/10.3109/14767058.2015.1031740. Laptook AR, Salhab W, Bhaskar B. Admission temperature of low birth weight infants: Predictors and associated morbidities. Pediatrics. 2007;119(3):e643–9. https://doi.org/10.1542/peds.2006-0943. World Health Organization. Thermal protection of the newborn : a practical guide. Book [Internet]; 1997. p. 68. Available from: https://apps.who.int/iris/bitstream/handle/10665/63986/WHO_RHT_MSM_97.2.pdf;jsessionid=4D411EC9439429CC27C36A844A1B811E?sequence=1 Mullany LC. Neonatal Hypothermia in Low-Resource Settings. Semin Perinatol. 2010;34:426–33. Vohra S, Frent G, Campbell V, Abbott M, Whyte R. Effect of polyethylene occlusive skin wrapping on heat loss in very low birth weight infants at delivery: a randomized trial. J Pediatr. 1999;134(5):547–51. https://doi.org/10.1016/S0022-3476(99)70238-6. Hsu KH, Chiang MC, Lin SW, Lin JJ, Wang YC, Lien R. Thermal blanket to improve thermoregulation in preterm infants: a randomized controlled trial. Pediatr Crit Care Med. 2015;16(7):637–43. https://doi.org/10.1097/PCC.0000000000000447. Mullany LC, Katz J, Khatry SK, Leclerq SC, Darmstadt GL, Tielsch JM. Neonatal hypothermia and associated risk factors among newborns of southern Nepal [Internet]. BMC Med. 2010;8 Available from: http://www.biomedcentral.com/1741-7015/8/43. Urubuto F, Agaba F, Choi J, Dusabimana R, Teteli R, Kumwami M, Conard C, O'Callahan C, Cartledge P. Prevalence, risk factors and outcomes of neonatal hypothermia at admission at a tertiary neonatal unit, Kigali, Rwanda - a cross-sectional study. J Matern Fetal Neonatal Med. 2021;34(17):2793–800. https://doi.org/10.1080/14767058.2019.1671334. de Almeida MF, Guinsburg R, Sancho GA, Rosa IR, Lamy ZC, Martinez FE, et al. Brazilian Network on Neonatal Research. Hypothermia and early neonatal mortality in preterm infants. J Pediatr. 2014;164(2):271–5.e1. https://doi.org/10.1016/j.jpeds.2013.09.049. Abd-El Hamid SA, Badr-El Din MM, Dabous NI, Saad KM. Effect of the use of a polyethylene wrap on the morbidity and mortality of very low birth weight infants in Alexandria university children’s hospital. J Egypt Public Health Assoc. 2012;87(5–6):104–8. https://doi.org/10.1097/01.EPX.0000421565.24496.d9. Perlman JM, Wyllie J, Kattwinkel J, Atkins DL, Chameides L, Goldsmith JP, Guinsburg R, Hazinski MF, Morley C, Richmond S, Simon WM, Singhal N, Szyld E, Tamura M, Velaphi S, Neonatal Resuscitation Chapter Collaborators. Part 11: neonatal resuscitation: 2010 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2010;122(16 Suppl 2):S516–38. https://doi.org/10.1161/CIRCULATIONAHA.110.971127. Laptook AR, Bell EF, Shankaran S, Boghossian NS, Wyckoff MH, Kandefer S, et al. Admission Temperature and Associated Mortality and Morbidity among Moderately and Extremely Preterm Infants. J Pediatr. 2018;192:53–59.e2. Audeh S, Smolkin T, Bental Y, Haramati Z, Blazer S, Litig E, et al. Does admission hypothermia predispose to intraventricular hemorrhage in very-low-birth-weight infants? Neonatology. 2011;100(4):373–9. https://doi.org/10.1159/000327370. Sharma D, Murki S, Kulkarni D, Pawale D, Vardhelli V, Anne RP, et al. The impact of a quality improvement project to reduce admission hypothermia on mortality and morbidity in very low birth weight infants. Eur J Pediatr. 2020;179(12):1851–8. https://doi.org/10.1007/s00431-020-03711-7. Liberati A, Altman DG, Tetzlaf J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62(10):e1–34. https://doi.org/10.1016/j.jclinepi.2009.06.006. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan — a web and mobile app for systematic reviews. Syst Rev. 2016;5:210. https://doi.org/10.1186/s13643-016-0384-4. The Joanna Briggs Institute. Joanna Briggs Institute Reviewer’s Manual 2018 [Available from: https://wiki.joannabriggs.org/display/MANUAL/Joanna+Briggs+Institute+Reviewer%27s+Manual Borenstein M, Hedges LV, Higgins J, Rothstein HR. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods. 2010;1(2):97–111. https://doi.org/10.1002/jrsm.12. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;1:1088–101. Duval S, Tweedie R. Trim and fl: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–63. https://doi.org/10.1111/j.0006-341X.2000.00455.x. Ogunles TA, Ogunfowora OB, Adekanmbi FA, Fetuga BM, Olanrewaju DM. Point-of-admission hypothermia among high-risk Nigerian newborns. BMC Pediatr. 2008;8(1):40. https://doi.org/10.1186/1471-2431-8-40. Neonatal Data Collection Group. Outcome of Inborn Compared with Outborn Very Low Birth Weight Infants Admitted to Level 3 Malaysian Nurseries. Med J Malaysia. 1995;50:1. Malaysian very low birth weight study group. A national study of risk factors associated with mortality in very low birthweight infants in the Malaysian neonatal intensive care units. J Faediatr Child Health. 1997;33(1):18–25. https://doi.org/10.1111/j.1440-1754.1997.tb00985.x. Demirel N, Bas AY, Zenciroglu A. Bronchopulmonary Dysplasia in Very Low Birth Weight Infants, Indian J Pediatr. 2009;76. https://doi.org/10.1007/s12098%2D%2D009%2D%2D0110—5. Das A, Shukla S, Rahman N, Gunzler D, Aughali N. Clinical Indicators of Late - Onset Sepsis Workup in very Low -Birth-Weight Infants in the Neonatal Intensive Care Unit. Am J Perinatol. 2016. https://doi.org/10.1055/s-0036-1579648. Lyu Y, Shah PS, Ye XY, Warre R, Piedboeuf B, Deshpandey A, et al. 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. https://doi.org/10.1001/jamapediatrics.2015.0277. Levi S, Taylor W. RN, Robinson LE, levy LI. Analysis of morbidity and outcomes of infants weighing less than 800 grams at birth. South Med J. 1984;77(8):8–986. https://doi.org/10.1111/j.1365-3156.2008.02113.x. Sodemann M, Nielsen J, Veirum J, Jakobsen MS, Biai S, Aaby P. Hypothermia of newborns is associated with excess mortality in the first 2 months of life in Guinea-Bissau, West Africa. 2008;13(8):980–6. https://doi.org/10.1111/j.1365-3156.2008.02113.x. 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. https://doi.org/10.1186/s12887-020-02024-w. Onalo R. Neonatal hypothermia in sub-Saharan Africa: a review. Niger J Clin Pract. 2013;16(2):129–38. https://doi.org/10.4103/1119-3077.110120. Trevisanuto D, Testoni D, de Almeida MFB. Maintaining normothermia: why and how? Semin Fetal Neonatal Med. 2018;23(5):333–9. https://doi.org/10.1016/j.siny.2018.03.009. Simiyu DE. Morbidity and mortality of low birth weight infants in the new born unit of Kenyatta national hospital, Nairobi. East Afr Med J. 2004;81(7):367–74. https://doi.org/10.4314/eamj.v81i7.9193. Yu VY, Downe L, Astbury J, et al. Perinatal factors and adverse outcome in extremely low birthweight infants. Arch Dis Child. 1986;61:554–8. https://doi.org/10.1136/adc.61.6.554. Jolly H, Molyneux P, Newell DJ. A controlled study of the effect on premature babies of temperature. J Pediatr. 1962;60(6):889–94. https://doi.org/10.1016/S0022-3476(62)80174-7.