Other investigators who participated in this study are listed in the Appendix on page xxx.
Elevated temperature and 6- to 7-year outcome of neonatal encephalopathy
Article first published online: 17 APR 2013
Copyright © 2012 American Neurological Association
Annals of Neurology
Volume 73, Issue 4, pages 520–528, April 2013
How to Cite
Laptook, A. R., McDonald, S. A., Shankaran, S., Stephens, B. E., Vohr, B. R., Guillet, R., Higgins, R. D., Das, A. and Extended Hypothermia Follow-up Subcommittee of the National Institute of Child Health and Human Development Neonatal Research Network (2013), Elevated temperature and 6- to 7-year outcome of neonatal encephalopathy. Ann Neurol., 73: 520–528. doi: 10.1002/ana.23843
- Issue published online: 21 MAY 2013
- Article first published online: 17 APR 2013
- Accepted manuscript online: 29 JAN 2013 04:52AM EST
- Manuscript Accepted: 30 NOV 2012
- Manuscript Revised: 20 NOV 2012
- Manuscript Received: 22 AUG 2012
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.
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).
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).
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. Ann Neurol 2013;73:520–528