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Cold treatment protects against infant disability and death from oxygen loss

Lowering infants' body temperature to about 92 degrees Fahrenheit within the first 6 hours of life reduces the chances of disability and death among full term infants who failed to receive enough oxygen or blood to the brain during birth. This finding was reported by researchers in the Neonatal Research Network of the National Institute of Child Health and Human Development, one of the National Institutes of Health.

The study appears in the October 13, 2005 New England Journal of Medicine.

"The experimental cooling of newborns to prevent death and injury from oxygen deprivation during birth is extremely promising," said NICHD Director Duane Alexander, M.D. "Yet it would be premature to implement the study results under any but the most carefully controlled and monitored circumstances. The potential for serious harm exists if the conditions followed in this protocol are not carried out precisely as they were during the study, by personnel skilled in their use."

The study was led by Seetha Shankaran, M.D., of the Division of NeonatalPerinatal Medicine, at Wayne State University School of Medicine in Detroit, one of the participating NICHD Neonatal Research Network study sites.

Hypoxic ischemic encephalopathy (HIE) occurs when an infant's brain fails to receive sufficient oxygen or sufficient blood before birth. HIE may occur hours before birth, or, in some cases, during labor and delivery. The condition may result from a variety of causes. These include compression of the placenta, tearing of the placenta from the uterine wall before birth, compression of the umbilical cord, and rupture of the uterus. Dr. Shankaran explained that HIE is estimated to occur from 0.5 to 1 times per every thousand births.

The study authors wrote that 10 percent of infants with moderate HIE die, as do 60 percent of infants with severe HIE. "Many, if not all," survivors of severe HIE experience major disability, they added.

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Contact: Robert Bock or Marianne Glass Miller
bockr@mail.nih.gov
301-496-5133
NIH/National Institute of Child Health and Human Development
12-Oct-2005


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