Benefits of hypothermia for infants continue through early childhood

May 30, 2012

A treatment to reduce the body temperatures of infants who experience oxygen deficiency at birth has benefits into early childhood, according to a follow-up study by a National Institutes of Health research network.

Children who received the hypothermia treatment as infants were more likely to have survived to ages 6 and 7, when they were evaluated again, than were children who received routine care, the study found. They were no more likely than the routine care group to experience a physical or cognitive impairment, it said. The report appears in the .

"The findings show that the use of this cooling technique after birth increases the chances of survival, without increasing the risk of ," said senior author Rosemary D. Higgins, M.D., of the Pregnancy and Perinatology Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

The study was conducted by Seetha Shankaran, M.D., of Wayne State University in Detroit, Dr. Higgins, and 25 other researchers in the NICHD Neonatal Research Network. In addition to NICHD, funding was also provided by the NIH's National Center for Research Resources and the National Center for Advancing Translational Sciences.

Infants born at term may fail to get enough oxygen, from blood loss or other birth complications. during the birth process is called hypoxic-ischemic encephalopathy, or HIE. In severe cases of HIE, death rates can reach 50 percent. Survivors often sustain brain damage, which can result in cerebral palsy, cognitive impairment, or hearing and vision loss. Even if they do not experience detectable brain damage, children who experience HIE at birth are at higher risk for learning disabilities, , and memory deficits. Severe oxygen deficiency at birth is also known as .

The current study was in follow up to an earlier study, conducted when the children were newborns and had received the body cooling treatment shortly after birth. That earlier study found that infants who received the cooling treatment were less likely to die or to develop moderate or severe disability than were the infants who received routine care. The original study assessed children's movement and cognitive abilities, hearing, and vision when they were 18 to 22 months old.

The study authors noted that neonatal intensive care units around the world have adopted this cooling technique to reduce the risk of death and disability among full-term infants who show signs of the brain dysfunction indicating .

"Testing at 18 months can identify major delays in a toddler's growth or brain development, but can't identify some of the more subtle cognitive or physical impairments that might become apparent in an older child," Dr. Higgins said. "This follow-up study confirms the original finding, showing that children who received the cooling treatment were more likely to survive, and that the survivors were no more likely to have a disability than the children in the untreated group."

The 208 children in the study were diagnosed with HIE within 6 hours of birth and treated in newborn intensive care units in the network. They were given the usual intensive care or treated with the body cooling technique. With this technique, cool water circulates inside a waterproof blanket beneath the infant. The cool water reduces the infant's temperature as low as 91.4 degrees Fahrenheit, and maintains it there 72 hours, after which caregivers allow the infant's body temperature to return to a normal.

To conduct the current study, the researchers analyzed data from follow-up visits conducted when these infants had turned 6 or 7 years old. The researchers compared rates of death and disability among those who got the cooling therapy and those who had received the usual intensive care. Mortality rates reflected the number of children who died between birth and age 7. The study found a 28 percent mortality rate in the hypothermia group, compared with 44 percent rate in the usual care group.

The researchers calculated the number of deaths and cases of severe disability as a single combined outcome. In the cooling group, the combined rate was 41 percent, compared with 60 percent in the usual care group. Severe disability involved motor function, cognitive ability, and vision. Rates of cerebral palsy, blindness, and epilepsy were similar between the two groups.

"Before the advent of this cooling treatment in 2005, doctors couldn't treat HIE, and many infants died or sustained brain injury," Dr. Shankaran said. "It's reassuring to see that the benefits of this practice, which have been widely documented at 18 months or 2 years of age, are apparent as these children grow."

Explore further: Enzyme controlling cell death paves way for treatment of brain damage in newborns

Related Stories

Enzyme controlling cell death paves way for treatment of brain damage in newborns

October 25, 2011
where the brain is starved of oxygen around the time of delivery – is normally treated by cooling the infant, but this only helps one baby in nine. New research from the Sahlgrenska Academy at the University of Gothenburg, ...

Recommended for you

Hormone discovery marks breakthough in understanding fertility

December 12, 2017
Scientists at The University of Nottingham have shown, for the first time, that a naturally occurring hormone plays a vital part in regulating a woman's fertility, a discovery that could lead to better diagnosis and treatment ...

Study reveals Viagra to be 'ineffective' for fetal growth restriction

December 8, 2017
A University of Liverpool led international clinical trial has found an anti-impotence drug to be ineffective at improving outcomes for pregnancies complicated by fetal growth restriction.

Obese first-time mums more likely to have premature babies

December 4, 2017
Obese women are up to three times more likely to have a premature child during their first pregnancy, according to a study from University College Dublin.

Stillbirth is not just stillbirth—more information is needed

December 4, 2017
Forty two babies are stillborn in Australia every week, and 60 per cent of them are recorded as "unexplained".

First baby from a uterus transplant in the US born in Dallas

December 2, 2017
The first birth as a result of a womb transplant in the United States has occurred in Texas, a milestone for the U.S. but one achieved several years ago in Sweden.

Living in a 'war zone' linked to delivery of low birthweight babies

November 28, 2017
Mums-to-be living in war zones/areas of armed conflict are at heightened risk of giving birth to low birthweight babies, finds a review of the available evidence published in the online journal BMJ Global Health.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.