Clinical Profile, Mortality, and Short-term Outcome in Asphyxiated Neonates Receiving Therapeutic Hypothermia in a Limited Resource Setting: A Cohort Study

Abstract

Background: This study aimed to evaluate the effectiveness of therapeutic hypothermia (TH) among asphyxiated newborns for reducing mortality, adverse clinical events, and short-term outcomes in comparison to asphyxiated newborns not receiving TH.Methods: This non-randomized cohort study was conducted at a tertiary care center. The statistical population of the study consisted of asphyxiated newborns admitted in the neonatal intensive care unit within 24 h of life meeting the laboratory and/or clinical criteria of severe birth asphyxia. Eligible newborns, who received TH, were labeled as recipients and those who did not receive TH were labeled as non-recipients.Results: Out of 176 studied neonates, 89 cases received TH, while 87 of the subjects did not receive TH. The recipients of TH had a 15.3% lower mortality rate, compared to non-recipients (P<0.05). The incidence of adverse clinical events was similar among both groups. At the time of discharge, 73.2% and 56.8%, 92.6% and 70.1%, 30.4% and 46.2% of recipients and non-recipients were neurologically normal (P=0.01), able to breastfeed (P<0.05), and required anti-epileptics (P<0.05), respectively.Conclusion It can be concluded that TH was an effective and feasible therapy with decreased death rate, better neurological status at discharge, and lesser need for anti-epileptics without increasing adverse clinical events at limited-resource settings using low-cost devices.

Keywords

• adverse clinical events
• limited resource settings
• neonatal mortality
• neurological outcome
• therapeutic hypothermia