低温和极早产儿的不良后果：一项系统综述。

IF 6.2 2区医学 Q1 PEDIATRICS

Pediatrics Pub Date : 2025-04-23 DOI:10.1542/peds.2024-069668

Marije Hogeveen,Lotty Hooft,Wes Onland

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引用次数: 0

摘要

目的研究胎龄（GA）小于 32 周的极早产儿入院体温过低与不良预后之间的关系。资料来源从开始到 2024 年 2 月 18 日的 CENTRAL、MEDLINE 和 Embase。数据提取两位审稿人按照《流行病学观察性研究的 Meta 分析》/《系统综述和 Meta 分析的首选报告项目》指南筛选了摘要和全文，提取了数据，并评估了偏倚风险。我们计划进行随机效应荟萃分析、亚组分析（GA、出生体重[BW]和收入）、敏感性分析（NOS、研究类型）和元回归分析（GA、BW）。结果包括死亡率和新生儿发病率：支气管肺发育不良（BPD）、脑室内出血（IVH）、坏死性小肠结肠炎（NEC）、视网膜病变（ROP）和败血症。平均低体温率为 42%（范围为 14%-88%）。低体温与死亡率增加有关（粗略赔率 [cOR] [95% CI] 2.02[1.84;2.21]；调整赔率 1.55[1.29;1.87]）。分组分析和敏感性分析均支持这些结果。元回归分析表明，效应大小与体重之间存在反向关系。低体温与较高的 BPD（cOR 1.13[1.01;1.27]）、IVH（cOR 1.37[1.17;1.61]）、ROP（cOR 1.55[1.41;1.69]）和败血症（cOR 1.32[1.16;1.51]）风险相关。这种关联的强度可能会受到BW、低体温和结果的定义以及排除标准的影响。鉴于我们研究结果的稳健性和样本量，相同的队列研究可能不会提供不同的见解。

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Hypothermia and Adverse Outcomes in Very Preterm Infants: A Systematic Review.

CONTEXT Hypothermia after very preterm birth, typically defined as a temperature less than 36 °C, is variably linked to neonatal mortality and morbidities. OBJECTIVE To examine the association between admission hypothermia and adverse outcomes in very preterm infants with a gestational age (GA) of less than 32 weeks. DATA SOURCES CENTRAL, MEDLINE, and Embase from inception to February 18, 2024. STUDY SELECTION Observational or randomized designs reporting on the association between admission temperature and adverse outcomes in very preterm infants. DATA EXTRACTION Two reviewers screened abstracts and full texts, extracted the data, and assessed the risk of bias, following Meta-analysis Of Observational Studies in Epidemiology /Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We planned to perform random-effects meta-analyses, subgroup (GA, birthweight [BW], and income), sensitivity analysis (NOS, study type), and meta-regression (GA, BW). Outcomes included mortality and neonatal morbidities: bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), retinopathy (ROP), and sepsis. RESULTS This review included 32 studies with >300 000 infants. The mean hypothermia rate was 42% (range 14%-88%). Hypothermia was associated with increased mortality (crude odds ratio [cOR] [95% CI] 2.02[1.84;2.21]; adjusted OR 1.55[1.29;1.87]). Subgroup and sensitivity analyses upheld these results. Meta-regression analysis showed an inversed relationship between effect size and BW. Hypothermia was associated with higher risks of BPD (cOR 1.13[1.01;1.27]), IVH (cOR 1.37[1.17;1.61]), ROP (cOR 1.55[1.41;1.69]), and sepsis (cOR 1.32[1.16;1.51]). LIMITATIONS Only observational studies were included. CONCLUSIONS Hypothermia is associated with increased mortality and morbidity in very preterm infants. The strength of this association may be influenced by BW, definitions of hypothermia and outcomes, and exclusion criteria. Given the robustness of our results and our sample size, identical cohort studies might not provide different insights.

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来源期刊

Pediatrics 医学-小儿科

CiteScore

12.80

自引率

5.00%

发文量

791

审稿时长

2-3 weeks

期刊介绍： The Pediatrics® journal is the official flagship journal of the American Academy of Pediatrics (AAP). It is widely cited in the field of pediatric medicine and is recognized as the leading journal in the field. The journal publishes original research and evidence-based articles, which provide authoritative information to help readers stay up-to-date with the latest developments in pediatric medicine. The content is peer-reviewed and undergoes rigorous evaluation to ensure its quality and reliability. Pediatrics also serves as a valuable resource for conducting new research studies and supporting education and training activities in the field of pediatrics. It aims to enhance the quality of pediatric outpatient and inpatient care by disseminating valuable knowledge and insights. As of 2023, Pediatrics has an impressive Journal Impact Factor (IF) Score of 8.0. The IF is a measure of a journal's influence and importance in the scientific community, with higher scores indicating a greater impact. This score reflects the significance and reach of the research published in Pediatrics, further establishing its prominence in the field of pediatric medicine.