Association between Hypothermia in the First Day of Life and Survival in the Preterm Infant

International audienceObjective: Hypothermia is associated with elevated mortality in the preterm infant. The preterm infant's thermoregulatory capacity is limited, and the thermal environment in an incubator is often perturbed by nursing procedures. We evaluated the incidence of a postnatal low body temperature and hypothermia in preterm infants and its association with mortality. Methods: We measured the lowest body temperature during the first 24 h of life (TBody Nadir 24h) and hypothermia (TBody Nadir 24h < 36.0 ° C) in preterm infants (gestational age: 230\textendash 316 weeks) in a neonatal intensive care unit. Prenatal and neonatal characteristics associated with mortality were identified in univariate and multivariable analyses. Results: A total of 102 preterm infants were included, with a mean gestational age at birth of 28.4 ± 2.3 weeks. The incidence of hypothermia during the first 24 h was 53%. A Cox multivariate regression model indicated that TBody Nadir 24h (hazard ratio (HR) [95% confidence interval]: 0.57 [0.36\textendash 0.90]; P = 0.017), gestational age (0.62 [0.50\textendash 0.76]; P < 0.001), and amine use (4.55 [2.01\textendash 10.28]; P = 0.001) were significantly associated with mortality. When considering a threshold for TBody Nadir 24h, a value of 35.0 ° C had the highest HR (3.30 [1.42\textendash 7.68]; P < 0.01). Conclusion: In preterm infants, the incidence of hypothermia during the first 24 h of life was 53%. TBody Nadir 24h had an influence on mortality, independently of other factors (notably birth weight and amine use). Within the framework of a quality improvement strategy, the implementation of a thermoregulation bundle is required to prevent hypothermia and decrease mortality in preterm infants. \textcopyright 2021 French Society of Pediatric