Transitory hypothermia as early prognostic factor in term newborns with intrauterine growth retardation

Abstract

Introduction. According to numerous researches, transitory hypothermia is a part of the neonatological energetic triangle and represents a significant prognostic factor within morbidity and mortality in newborns with intrauterine growth retardation (IUGR), that are, due to their characteristics, more inclined to transitory hypothermia. Objective. The aim of the study was an analysis of frequency of transitory hypothermia in term newborns with IUGR, as well as an analysis of frequency of the most frequent pathological conditions typical of IUGR newborns depending on the presence of transitory hypothermia after birth (hypoglycaemia, perinatal asphyxia, hyperbilirubinaemia and hypocalcaemia). Methods. The study included 143 term newborns with IUGR treated at the Neonatology Ward of the Gynaecology- Obstetrics Clinic “Narodni front”, Belgrade. The newborns were divided into two groups: the one with registered transitory hypothermia - the observed group, and the one without transitory hypothermia - the control group. The data analysis included the analysis of the frequency of transitory hypothermia depending on gestation and body mass, as well as the analysis of pathological conditions (perinatal asphyxia, hypoglycaemia, hypocalcaemia, hyperbilirubinaemia) depending on the presence of hypothermia.The analysis was done by statistical tests of analytic and descriptive statistics. Results. In morbidity structure dominate hypothermia (65.03%), hypoglycaemia (43.36%), perinatal asphyxia (37.76%), hyperbilirubinaemia (30.77%), hypocalcaemia (25.17%). There were 93 newborns in the observed group, and 50 in the control one. Mean value of the measured body temperature was 35.9°C. 20 newborns (32.26%) had moderate hypothermia, and 73 newborns (67.74%) had mild hypothermia. In the observed group, average gestation was 39.0 weeks, and 39.6 (p<0.01) in the control group. Average body mass at birth in the whole group was 2339 g: 2214 g in the observed and 2571 g in the control group. The frequency of hypoglycaemia in the observed group was 53.8%, and 24% in the control group (p<0.01). In the observed group, the frequency of pH<7.25 was 38.71%, and 14% in the control group (p<0.05). The frequency of hyperbilirubinaemia was 38.71% in the observed group, and 16% in the control group (p<0.01). The frequency of hypocalcaemia was 32.26% in the observed, and 12% in the control group (p<0.01). Conclusion. Transitory hypothermia in the first ten hours of life represents a significant risk factor for deepening hypoglycaemia, asphyxia, hyperbilirubinaemia and hypocalcaemia in term newborns with IUGR.

Keywords

• newborn
• transitory hypothermia
• intrauterine growth retardation