|Effect of inborn vs. outborn delivery on neurodevelopmental outcomes in infants with hypoxic-ischemic encephalopathy: secondary analyses of the NICHD whole-body cooling trial.|
|PMID: 22914450 Owner: NLM Status: MEDLINE|
|BACKGROUND: The effect of birth location on hypothermia-related outcomes has not been rigorously examined in the literature. In this study, we determined whether birth location had an impact on the benefits of whole-body cooling to 33.5 °C for 72 h in term infants (n = 208) with hypoxic-ischemic encephalopathy (HIE) who participated in the Neonatal Research Network (NRN) randomized controlled trial.
METHODS: Heterogeneity by birth location was examined with respect to cooling treatment for the 18-mo primary outcomes (death, moderate disability, severe disability) and secondary outcomes (death, components of disability), and in-hospital organ dysfunction. Logistic regression models were used to generate adjusted odds ratios.
RESULTS: Infants born at a location other than an NRN center (outborn) (n = 93) experienced significant delays in initiation of therapy (mean (SD): 5.5 (1.1) vs. 4.4 (1.2) h), lower baseline temperatures (36.6 (1.2) vs. 37.1 (0.9) °C), and more severe HIE (43 vs. 29%) than infants born in an NRN center (inborn) (n = 115). Maternal education <12 y (50 vs. 14%) and African-American ethnicity (43 vs. 25%) were more common in the inborn group. When adjusted for NRN center and HIE severity, there were no significant differences in 18-mo outcomes or in-hospital organ dysfunction between inborn and outborn infants.
CONCLUSION: Although limited by sample size and some differences in baseline characteristics, the study showed that birth location does not appear to modify the treatment effect of hypothermia after HIE.
|Girija Natarajan; Athina Pappas; Seetha Shankaran; Abbot R Laptook; Michele Walsh; Scott A McDonald; Richard A Ehrenkranz; Jon E Tyson; Ronald N Goldberg; Rebecca Bara; Rosemary D Higgins; Abhik Das; Breda Munoz|
|Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2012-07-25|
|Title: Pediatric research Volume: 72 ISSN: 1530-0447 ISO Abbreviation: Pediatr. Res. Publication Date: 2012 Oct|
|Created Date: 2012-10-03 Completed Date: 2013-03-05 Revised Date: 2013-08-12|
Medline Journal Info:
|Nlm Unique ID: 0100714 Medline TA: Pediatr Res Country: United States|
|Languages: eng Pagination: 414-9 Citation Subset: IM|
|Department of Pediatrics, Wayne State University, Detroit, Michigan, USA. firstname.lastname@example.org|
|APA/MLA Format Download EndNote Download BibTex|
Developmental Disabilities / diagnosis, etiology*, mortality, physiopathology
Health Services Accessibility
Hypothermia, Induced* / adverse effects, mortality
Hypoxia-Ischemia, Brain / mortality, physiopathology, therapy*
Nervous System / physiopathology*
Severity of Illness Index
|M01 RR125/RR/NCRR NIH HHS; M01 RR16587/RR/NCRR NIH HHS; M01 RR30/RR/NCRR NIH HHS; M01 RR32/RR/NCRR NIH HHS; M01 RR39/RR/NCRR NIH HHS; M01 RR44/RR/NCRR NIH HHS; M01 RR6022/RR/NCRR NIH HHS; M01 RR633/RR/NCRR NIH HHS; M01 RR70/RR/NCRR NIH HHS; M01 RR750/RR/NCRR NIH HHS; M01 RR80/RR/NCRR NIH HHS; M01 RR8084/RR/NCRR NIH HHS; U10 HD021385/HD/NICHD NIH HHS; U10 HD21364/HD/NICHD NIH HHS; U10 HD21373/HD/NICHD NIH HHS; U10 HD21385/HD/NICHD NIH HHS; U10 HD21397/HD/NICHD NIH HHS; U10 HD27851/HD/NICHD NIH HHS; U10 HD27853/HD/NICHD NIH HHS; U10 HD27856/HD/NICHD NIH HHS; U10 HD27871/HD/NICHD NIH HHS; U10 HD27880/HD/NICHD NIH HHS; U10 HD27904/HD/NICHD NIH HHS; U10 HD34216/HD/NICHD NIH HHS; U10 HD36790/HD/NICHD NIH HHS; U10 HD40461/HD/NICHD NIH HHS; U10 HD40492/HD/NICHD NIH HHS; U10 HD40521/HD/NICHD NIH HHS; U10 HD40689/HD/NICHD NIH HHS; UL1 RR24139/RR/NCRR NIH HHS|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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