Effect of Elevated Temperature on Immediate Neurodevelopmental Outcome in Term Neonates with Hypoxic-Ischemic Encephalopathy

Authors

  • Bithi Debnath Assistant Professor, Department of Pediatric Neurology, National Institute of Neurosciences and Hospital, Sher-EBangla Nagar, Dhaka
  • Naila Zaman Khan Department of Pediatric Neuroscience, Bangladesh Institute of Child Health & Dhaka Shishu (Children`s) Hospital, Sher-E-Bangla Nagar, Dhaka
  • Dilara Begum Developmental therapists, Shishu Bikash Kendra, Dhaka Shishu (Children`s) Hospital, Sher-E-Bangla Nagar, Dhaka
  • Asma Begum Shilpi Senior Instructor (Developmental therapy), Shishu Bikash Kendra, Directorate General of Health Services, Mohakhali, Dhaka
  • Shaheen Akter Professor, Department of Pediatrics, Enam Medical College & Hospital, Savar, Dhaka

DOI:

https://doi.org/10.3329/jemc.v9i3.43244

Keywords:

Hypoxic-ischemic encephalopathy (HIE); Neurodevelopmental outcome; Temperature; Term neonate; Developmental domain; Neonatal intensive care unit

Abstract

Background: Among term infants, hypoxic-ischemic encephalopathy due to acute perinatal asphyxia remains an important cause of neurodevelopmental deficits in childhood. Treatment is currently limited to supportive intensive care, without any specific brain-oriented therapy.

Objective: To determine whether the risk of death or moderate/severe neurodevelopmental impairment in term infants with hypoxic-ischemic encephalopathy increases with relatively high skin or rectal temperature between 12 and 72 hours of birth.

Materials and Methods: This was a prospective observational study. Asphyxiated newborns who came within 12 hours of birth were enrolled in this study. Both axillary and rectal temperature were recorded 6 hourly for 72 hours and each infant`s temperature for each site were rank ordered. Then mean of all axillary and rectal temperatures of each neonate was calculated. Outcomes were related to temperatures in logistic regression analyses for the elevated/relatively high temperatures and normal/low temperatures group, with adjustment of the level of encephalopathy and gender.

Results: The mean axillary temperature was 36.07 ± 6.10C and in 25.71%, 11.92% and 6.32% cases axillary temperatures were >370C, >37.50C and >380C respectively. The mean rectal temperature was 36.8 ± 60C, and in 43.53%, 30.02% and 19.97% cases rectal temperatures were >370C, >37.50C and >380C respectively. Mean ambient temperature was 26.170C. There was significant correlation between axillary and rectal temperatures (r=0.889). For elevated temperature, the odds of death or moderate to severe impairment increased 8.9-fold (CI 0.906–88.18) and the odds of death alone increased 4.6-fold (CI 0.373–56.83). The odds of impairment increased 1.84-fold (CI 0.45– 7.50).

Conclusion: Relatively high temperature during usual care after hypoxic-ischemia in term neonates was associated with adverse neurodevelopmental outcomes.

J Enam Med Col 2019; 9(3): 160-165

Downloads

Download data is not yet available.
Abstract
382
PDF
357

Downloads

Published

2019-09-22

How to Cite

Debnath, B., Khan, N. Z., Begum, D., Shilpi, A. B., & Akter, S. (2019). Effect of Elevated Temperature on Immediate Neurodevelopmental Outcome in Term Neonates with Hypoxic-Ischemic Encephalopathy. Journal of Enam Medical College, 9(3), 160–165. https://doi.org/10.3329/jemc.v9i3.43244

Issue

Section

Original Articles