Clinical Profile, Mortality, and Short-term Outcome in Asphyxiated Neonates Receiving Therapeutic Hypothermia in a Limited Resource Setting: A Cohort Study

Background: This study aimed to evaluate the effectiveness of therapeutic hypothermia (TH) among asphyxiated newborns for reducing mortality, adverse clinical events, and short-term outcomes in comparison to asphyxiated newborns not receiving TH.Methods: This non-randomized cohort study was conducted at a tertiary care center. The statistical population of the study consisted of asphyxiated newborns admitted in the neonatal intensive care unit within ۲۴ h of life meeting the laboratory and/or clinical criteria of severe birth asphyxia. Eligible newborns, who received TH, were labeled as recipients and those who did not receive TH were labeled as non-recipients.Results: Out of ۱۷۶ studied neonates, ۸۹ cases received TH, while ۸۷ of the subjects did not receive TH. The recipients of TH had a ۱۵.۳% lower mortality rate, compared to non-recipients (P<۰.۰۵). The incidence of adverse clinical events was similar among both groups. At the time of discharge, ۷۳.۲% and ۵۶.۸%, ۹۲.۶% and ۷۰.۱%, ۳۰.۴% and ۴۶.۲% of recipients and non-recipients were neurologically normal (P=۰.۰۱), able to breastfeed (P<۰.۰۵), and required anti-epileptics (P<۰.۰۵), respectively.Conclusion It can be concluded that TH was an effective and feasible therapy with decreased death rate, better neurological status at discharge, and lesser need for anti-epileptics without increasing adverse clinical events at limited-resource settings using low-cost devices.  

Keywords:

adverse clinical events , limited resource settings , Neonatal mortality , neurological outcome , Therapeutic hypothermia