TY - JOUR
T1 - Depression at birth in term infants exposed to maternal chorioamnionitis
T2 - Does neonatal fever play a role?
AU - Shalak, Lina F.
AU - Perlman, Jeffrey M.
AU - Jackson, Gregory L.
AU - Laptook, Abbot R.
PY - 2005/7
Y1 - 2005/7
N2 - Objectives: (1) To determine the incidence and the time course of elevated temperature following delivery in term infants with clinical chorioamnionitis (CHORIO) and (2) to determine if the extent of temperature elevation at birth is associated with increased likelihood of NICU Admissions, birth depression, or with short-term neurological abnormalities. Design/methods: The infants were divided into two groups based on the median admission rectal temperature of 37.8°C for the cohort. Depression at birth was defined as either the need of positive pressure ventilation for >2 minutes, intubation, or Apgar score <6 at 5 minutes. Neurological examination and assessment of encephalopathy (Sarnat staging) was performed at birth and daily thereafter, by one investigator blinded to temperature findings. Results: Infants with higher rectal temperature at 30 minutes of life were more likely to be admitted to NICU: OR (2.8, 95% confidence interval (CI) [1.8 to 4.3], and were more likely to have birth depression OR (3.95%CI [1.4 to 6.5]). For infants in NICU, a rectal temperature above 37.8°C was present in 87% in the delivery room, persisted in 47% at 30 minutes, and declined to a normal temperature at 60 minutes of life in the absence of medical interventions. There was no relationship between neurological scores and neonatal temperature. Conclusions: Term infants exposed to CHORIO who had a higher neonatal temperature at 30 minutes of life, were more likely to be admitted to the NICU and to have birth depression, than infants with lesser degree of temperature elevation after birth. Within the NICU group, the extent of temperature elevation was not associated with worse neurological outcomes.
AB - Objectives: (1) To determine the incidence and the time course of elevated temperature following delivery in term infants with clinical chorioamnionitis (CHORIO) and (2) to determine if the extent of temperature elevation at birth is associated with increased likelihood of NICU Admissions, birth depression, or with short-term neurological abnormalities. Design/methods: The infants were divided into two groups based on the median admission rectal temperature of 37.8°C for the cohort. Depression at birth was defined as either the need of positive pressure ventilation for >2 minutes, intubation, or Apgar score <6 at 5 minutes. Neurological examination and assessment of encephalopathy (Sarnat staging) was performed at birth and daily thereafter, by one investigator blinded to temperature findings. Results: Infants with higher rectal temperature at 30 minutes of life were more likely to be admitted to NICU: OR (2.8, 95% confidence interval (CI) [1.8 to 4.3], and were more likely to have birth depression OR (3.95%CI [1.4 to 6.5]). For infants in NICU, a rectal temperature above 37.8°C was present in 87% in the delivery room, persisted in 47% at 30 minutes, and declined to a normal temperature at 60 minutes of life in the absence of medical interventions. There was no relationship between neurological scores and neonatal temperature. Conclusions: Term infants exposed to CHORIO who had a higher neonatal temperature at 30 minutes of life, were more likely to be admitted to the NICU and to have birth depression, than infants with lesser degree of temperature elevation after birth. Within the NICU group, the extent of temperature elevation was not associated with worse neurological outcomes.
UR - http://www.scopus.com/inward/record.url?scp=22144482718&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=22144482718&partnerID=8YFLogxK
U2 - 10.1038/sj.jp.7211326
DO - 10.1038/sj.jp.7211326
M3 - Article
C2 - 15858605
AN - SCOPUS:22144482718
SN - 0743-8346
VL - 25
SP - 447
EP - 452
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 7
ER -