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A recent study indicates that cooling therapy, aimed at lowering the body temperature of preterm infants suffering from hypoxic ischemic encephalopathy (HIE), may not provide the benefits previously observed in full-term infants. The research, funded by the National Institutes of Health (NIH), focuses on preterm infants born between 33 and 35 weeks of gestation, revealing that the risks associated with cooling therapy outweigh any potential advantages in this population.
Historically, cooling treatment has been found effective in reducing the likelihood of death and disability in infants born after 36 weeks gestation by lowering body temperatures to around 92 degrees Fahrenheit. However, the findings from this new research suggest that similar outcomes do not apply to preterm infants affected by HIE.
The investigation was led by Dr. Roger G. Faix from the University of Utah, along with multiple collaborators from 19 different newborn research centers. The results of this study are published in JAMA Pediatrics and received funding from NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).
HIE is often caused by oxygen deprivation during labor, which can occur due to various complications, including umbilical cord compression or uterine tears. In this study, researchers examined 188 preterm infants diagnosed with HIE between 2015 and 2020. Of these, 88 infants were randomly selected to receive cooling therapy, while 80 were kept at a normal body temperature. The children were monitored for outcomes such as mortality and moderate to severe disabilities at the age of 18 to 22 months. The results revealed that 35% of those subjected to cooling therapy experienced either death or disability, compared to 29% in the control group. Notably, death rates were 20% among the cooled infants, compared to 12% for those who received standard care.
Overall, preterm infants who underwent cooling treatment exhibited a 74% increased risk of death or disability when compared to their peers who received normal temperature care, along with an 87% heightened risk of mortality. These findings underscore the importance of carefully evaluating treatment approaches for vulnerable populations like preterm infants, especially as the application of cooling therapy has risen in recent years without substantial evidence to support its efficacy in this specific age group.
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