关键词: 低体温, 早产儿, 极低出生体重儿, 危险因素, 质量改进

Abstract: Objective To describe the distribution of temperature at admission in very low birth weight infants (VLBWIs) and/or premature infants with a gestational age≤32 weeks, and to analyze the risk factors of hypothermia, in order to provide clinical evidence for reducing the incidence of admission hypothermia. Methods From 1st January, 2019 to 31st December, 2020, 248 VLBWIs (birth weight＜1 500 g) and/or premature infants with gestational age≤32 weeks admitted to Neonatal Intensive Care Unit(NICU) of Liaocheng People′s Hospital were enrolled in this study.Then the participants were divided into normothermia group(36.5℃-37.5℃,n=122),mild hypothermia group(36.0℃-36.4℃, n=98) and moderate hypothermia group(32.0℃-35.9℃, n=27).The admission temperature, general and perinatal conditions of the three groups were recorded and compared. Results The admission temperature ranged from 34.8℃ to 38.0℃ in 248 VLBWIs (birth weight＜1 500 g) and/or premature infants with gestational age≤32 weeks, and the average temperature is (36.37±0.44)℃.Univariate analysis showed that compared with the normothermia group, the gestational age and the proportion of cesarean section were lower in moderate hypothermia group (H=12.316, χ²=7.739,P<0.05), and the proportion of endotracheal intubation at birth was higher moderate hypothermia group (χ²=22.907, P<0.05).Compared with the normothermia group, the birth weight of infants in mild and moderate hypothermia group was lower (H=26.060,P<0.05), while the proportion of 5 min Apgar score ≤7 and resuscitation were higher (χ²=27.594,23.879, P<0.05).Multivariate Logistic regression analysis showed that higher birth weight was associated with lower risk of hypothermia (OR=0.997, 95%CI: 0.996-0.999), while multiple births and resuscitation were independently risk factors of hypothermia (OR=2.279, 95%CI:1.106-4.694; OR=3.265, 95%CI:1.209-8.819, P＜0.05). Conclusions The occurrence of hypothermia in VLBWIs and/or premature infants with gestational age≤32 weeks is associated with a number of factors, including birth weight, multiple births and resuscitation by asphyxia as independent risk factors for hypothermia, and the incidence of admission hypothermia can be reduced through continuous quality improvement programs.

Key words: hypothermia, premature infants, very low birth weight infant, risk factor, quality improvement