Cohort study from 11 European countries highlighted differences in the use and efficacy of hypothermia prevention strategies after very preterm birth
Wilson, Emilija; Zeitlin, Jennifer; Piedvache, Aurélie; Misselwitz, Bjoern; Christensson, Kyllike; Maier, Rolf F.; Norman, Mikael; Edstedt Bonamy, Anna Karin; Martens, E.; Martens, G.; Van Reempts, P.; Boerch, K.; Hasselager, A.; Huusom, L.; Pryds, O.; Weber, T.; Toome, L.; Varendi, H.; Ancel, P. Y.; Blondel, B.; Burguet, A.; Jarreau, P. H.; Truffert, P.; Schmidt, S.; Gortner, L.; Baronciani, D.; Gargano, G.; Agostino, R.; DiLallo, D.; Franco, F.; Carnielli, V.; Cuttini, M.; Koopman-Esseboom, C.; van Heijst, A.; Nijman, J.; Gadzinowski, J.; Mazela, J.; Graça, L. M.; Machado, M. C.; Rodrigues, C.; Rodrigues, T.; Barros, H.; Boyle, E.; Draper, E. S.; Manktelow, B. N.; Fenton, A. C.; Milligan, D. W.A.; Bonet, M.; the EPICE Research Group
(2018) Acta Paediatrica, International Journal of Paediatrics, volume 107, issue 6, pp. 958 - 966
(Article)
Abstract
Aim: This study investigated the different strategies used in 11 European countries to prevent hypothermia, which continues to affect a large proportion of preterm births in the region. Methods: We examined the association between the reported use of hypothermia prevention strategies in delivery rooms and body temperatures on admission to
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neonatal intensive care units (NICUs) in 5861 infants born at 22 + 0 to 31 +6 weeks of gestation. The use of plastic bags, wraps, caps, exothermic heat and mattresses was investigated. Results: The proportion of infants born in units that systematically used one or more hypothermia prevention strategies was 88.2% and 50.9% of those infants were hypothermic on admission to NICUs. Of the 9.6% born in units without systematic hypothermia prevention, 73.2% were hypothermic. Only 2.2% of infants were born in units with no reported prevention strategies. Lower gestational age increased the probability of hypothermia. No significant differences were found between the various hypothermia prevention strategies. Hyperthermia was seen in 4.8% of all admitted infants. Conclusion: Very preterm infants had lower risks of hypothermia on NICU admission if the unit used systematic prevention strategies. All the strategies had similar effects, possibly due to implementation rather than a strategy's specific efficacy.
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Keywords: European study, Hyperthermia, Hypothermia prevention, Neonatal intensive care, Very preterm birth, Pediatrics, Perinatology, and Child Health
ISSN: 0803-5253
Publisher: Wiley-Blackwell
Note: Funding Information: Organisational support was provided by INSERM, EU7FP (EPICE). Financial support was provided by the European Union’s Seventh Framework Programme (FP7/2007-2013) under grant agreement n°259882. Swedish funding: Swedish Order of Freemasons’ Foundation for Children’s Welfare in Stockholm; Martin Rinds Foundation; Stockholm County Council Clinical Research appointment (AKEB). France funding: French Institute of Public Health Research/Institute of Public Health and its partners the French Health Ministry, the National Institute of Health and Medical Research, the National Institute of Cancer, and the National Solidarity Fund for Autonomy and grant ANR-11-EQPX-0038 from the National Research Agency through the French Equipex Program of Investments in the Future and the PremUp Foundation. Funding Information: Organisational support was provided by INSERM, EU7FP (EPICE). Financial support was provided by the European Union's Seventh Framework Programme (FP7/2007-2013) under grant agreement n?259882. Swedish funding: Swedish Order of Freemasons? Foundation for Children's Welfare in Stockholm; Martin Rinds Foundation; Stockholm County Council Clinical Research appointment (AKEB). France funding: French Institute of Public Health Research/Institute of Public Health and its partners the French Health Ministry, the National Institute of Health and Medical Research, the National Institute of Cancer, and the National Solidarity Fund for Autonomy and grant ANR-11-EQPX-0038 from the National Research Agency through the French Equipex Program of Investments in the Future and the PremUp Foundation. The members of the EPICE research group were as follows. Belgium (Flanders) E Martens, G Martens and P Van Reempts. Denmark (Eastern Region) K Boerch, A Hasselager, L Huusom, O Pryds and T Weber. Estonia L Toome and H Varendi. France (Burgundy, Ile-de France and Northern Region) PY Ancel, B Blondel, A Burguet, PH Jarreau and P Truffert. Germany (Hesse) RF Maier, B Misselwitz and S Schmidt, (Saarland) L Gortner. Italy (Emilia Romagna) D Baronciani and G Gargano, (Lazio) R Agostino, D DiLallo and F Franco, (Marche) V Carnielli and M Cuttini. Netherlands (Eastern & Central) C Koopman-Esseboom, A van Heijst and J Nijman. Poland (Wielkopolska) J Gadzinowski and J Mazela. Portugal (Lisbon and Tagus Valley) LM Gra?a and MC Machado, (Northern region) C Rodrigues, T Rodrigues and H Barros. Sweden (Stockholm): AK Bonamy, M Norman and E Wilson. UK (East Midlands and Yorkshire and Humber) E Boyle, ES Draper and BN Manktelow, (Northern Region) AC Fenton, DWA Milligan. INSERM, Paris J Zeitlin, M Bonet and A Piedvache. Publisher Copyright: ©2018 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd
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