{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:16:30Z","timestamp":1790180190943,"version":"4.1.0"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"16","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>\n            Objective\u2003We aimed to investigate the relationship between admission hypothermia and outcomes among very preterm infants (VPIs) in neonatal intensive care units (NICUs) in China. We also investigated the frequency of hypothermia in VPIs in China and the variation in hypothermia across Chinese Neonatal Network (CHNN) sites.<\/jats:p><jats:p>\n            Study Design\u2003This retrospective cohort study enrolled infants with 240\/7 to 316\/7 weeks of gestation with an admission body temperature \u226437.5\u2009\u00b0C who were admitted to CHNN-participating NICUs between January 1 and December 31, 2019.<\/jats:p><jats:p>\n            Results\u2003A total of 5,913 VPIs were included in this study, of which 4,075 (68.9%) had hypothermia (&lt;36.5\u2009\u00b0C) at admission. The incidence of admission hypothermia varied widely across CHNN sites (9\u2013100%). Lower gestational age (GA), lower birth weight, antenatal steroid administration, multiple births, small for GA, Apgar scores &lt;7 at the 5th minute, and intensive resuscitation were significantly associated with admission hypothermia. Compared with infants with normothermia (36.5\u201337.5\u2009\u00b0C), the adjusted odds ratios (ORs) for composite outcome among infants with admission hypothermia &lt;35.5\u2009\u00b0C increased to 1.47 (95% confidence interval [CI], 1.15\u20131.88). The adjusted ORs for mortality among infants with admission hypothermia (36.0\u201336.4 and &lt;35.5\u2009\u00b0C) increased to 1.41 (95% CI, 1.09\u20131.83) and 1.93 (95% CI, 1.31\u20132.85), respectively. Admission hypothermia was associated with a higher likelihood of bronchopulmonary dysplasia, but was not associated with necrotizing enterocolitis \u2265stage II, severe intraventricular hemorrhage, cystic periventricular leukomalacia, severe retinopathy of prematurity, or sepsis.<\/jats:p><jats:p>\n            Conclusion\u2003Admission hypothermia remains a common problem for VPIs in a large cohort in China and is associated with adverse outcomes. Continuous quality improvement of admission hypothermia in the future may result in a substantial improvement in the outcomes of VPIs in China.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0044-1786873","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T23:44:42Z","timestamp":1716853482000},"page":"2298-2307","source":"Crossref","is-referenced-by-count":5,"title":["Association between Neonatal Outcomes and Admission Hypothermia among Very Preterm Infants in Chinese Neonatal Intensive Care Units: A Multicenter Cohort Study"],"prefix":"10.1055","volume":"41","author":[{"given":"Wenchao","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neonatology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanchen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Children's Hospital of Fudan University, Minhang District, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Children's Hospital of Fudan University, Minhang District, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Children's Hospital of Fudan University, Minhang District, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoo K.","family":"Lee","sequence":"additional","affiliation":[{"name":"Maternal Infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheree","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, John A. Burns School of Medicine and Kapiolani Medical Center for Women and Children, University of Hawaii, Honolulu, Hawaii"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shanghai Children's Medical Center, National Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chongbing","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingxia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neonatology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,5,27]]},"reference":[{"key":"ref1","first-page":"1","volume-title":"Thermal protection of the newborn: a practical guide","author":"World Health Organization","year":"1993"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"8","DOI":"10.7812\/TPP\/12-130","article-title":"Elimination of admission hypothermia in preterm very low-birth-weight infants by standardization of delivery room management","volume":"17","author":"M Manani","year":"2013","journal-title":"Perm J"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"e2020349","DOI":"10.1590\/1984-0462\/2022\/40\/2020349","article-title":"Hypothermia and neonatal morbimortality in very low birth weight preterm infants","volume":"40","author":"R CO Cordeiro","year":"2021","journal-title":"Rev Paul Pediatr"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"e150277","DOI":"10.1001\/jamapediatrics.2015.0277","article-title":"Association between admission temperature and mortality and major morbidity in preterm infants born at fewer than 33 weeks' gestation","volume":"169","author":"Y Lyu","year":"2015","journal-title":"JAMA Pediatr"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/1741-7015-11-24","article-title":"The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival","volume":"11","author":"K Lunze","year":"2013","journal-title":"BMC Med"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"e051175","DOI":"10.1136\/bmjopen-2021-051175","article-title":"Chinese Neonatal Network: a national protocol for collaborative research and quality improvement in neonatal care","volume":"12","author":"M Hei","year":"2022","journal-title":"BMJ Open"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"e2118904","DOI":"10.1001\/jamanetworkopen.2021.18904","article-title":"Assessment of neonatal intensive care unit practices, morbidity, and mortality among very preterm infants in China","volume":"4","author":"Y Cao","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"711200","DOI":"10.3389\/fped.2021.711200","article-title":"Data quality improvement and internal data audit of the Chinese Neonatal Network Data Collection System","volume":"9","author":"J Sun","year":"2021","journal-title":"Front Pediatr"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/S0022-3476(78)80282-0","article-title":"Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm","volume":"92","author":"L A Papile","year":"1978","journal-title":"J Pediatr"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"E81","DOI":"10.1503\/cmaj.190940","article-title":"Outcomes and care practices for preterm infants born at less than 33 weeks' gestation: a quality-improvement study","volume":"192","author":"S K Lee","year":"2020","journal-title":"CMAJ"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00000658-197801000-00001","article-title":"Neonatal necrotizing enterocolitis. 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Laptook","year":"2018","journal-title":"J Pediatr"},{"issue":"06","key":"ref31","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1053\/j.semperi.2010.09.007","article-title":"Neonatal hypothermia in low-resource settings","volume":"34","author":"L C Mullany","year":"2010","journal-title":"Semin Perinatol"},{"issue":"04","key":"ref32","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.ijpam.2022.12.001","article-title":"Admission temperature and neonatal outcomes - single-centre experience in Saudi Arabia","volume":"9","author":"A Fneish","year":"2022","journal-title":"Int J Pediatr Adolesc Med"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1159\/000327370","article-title":"Does admission hypothermia predispose to intraventricular hemorrhage in very-low-birth-weight infants?","volume":"100","author":"S Audeh","year":"2011","journal-title":"Neonatology"},{"issue":"01","key":"ref34","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s40748-021-00134-6","article-title":"Outcomes of neonatal hypothermia among very low birth weight infants: a meta-analysis","volume":"7","author":"S OO Mohamed","year":"2021","journal-title":"Matern Health Neonatol Perinatol"},{"issue":"07","key":"ref35","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1007\/s00431-019-03386-9","article-title":"Admission hypothermia, neonatal morbidity, and mortality: evaluation of a multicenter cohort of very low birth weight preterm infants according to relative performance of the center","volume":"178","author":"J P de Siqueira Caldas","year":"2019","journal-title":"Eur J Pediatr"},{"issue":"01","key":"ref36","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.exer.2009.09.019","article-title":"Hypothermia prevents the development of ischemic proliferative retinopathy induced by severe 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