PhD Scientific Days 2026

Poster Session 1.S - Conservative Medicine

Therapeutic Hypothermia for Preterm Infants: the Hungarian Experience

Name of the presenter

Csekő, Anna Judit

Institute/workplace of the presenter

Department of Neonatology, Semmelweis University

Authors

Anna Judit Csekő¹
1: Department of Neonatology, Semmelweis University

Text of the abstract

Introduction
Therapeutic hypothermia (TH) is standard of care after a severe hypoxic-ischemic event in neonates >35 weeks’ gestation. In preterm infants however, only limited data are available on the safety and efficacy of TH.
Aims
We will compare short-term outcomes among preterm infants across varying degrees of immaturity following severe hypoxic-ischemic insult at birth and assess potential safety concerns or benefits associated with TH.
Methods
In this retrospective cohort study, we reviewed the Hungarian Perinatal Registry for preterm infants [gestational age (GA) 30-35 weeks)] born between 2005-2023. Subjects were selected based on having concurrent 5-minute Apgar score ≤7, base deficit (BD) ≥14 mmol/L and a serum lactate level of ≥7.0 mmol/L. The decision to use TH was made by the attending neonatologist. We compared neonatal outcomes between groups of less mature (GA 30-32 weeks) and more mature (GA 33-35 weeks) infants who either received TH or standard intensive care.
Results
336 patients (n=147 less mature and n=189 more mature) met inclusion criteria. Less mature infants were less likely to be treated with TH (9.5% vs 30.2%). Complications associated with immaturity were intraventricular haemorrhage, anaemia, surfactant treatment, longer respiratory support and longer hospital stay. Temperature stability during cooling was better among less mature infants. TH-treated infants suffered from more severe initial hypoxic-ischemic insults, received vasopressor/inotropic support, hydrocortisone and FFP transfusions more frequently, yet mortality remained similar between groups. A tendency for a higher risk of hypoxic respiratory failure treated with inhaled nitric oxide (iNO) among cooled infants was driven by the less mature preterm infants.
Conclusion
This is the first retrospective study reporting on TH-treated preterm infants as immature as 30-32 weeks’ gestation. We observed a possible added risk of TH for hypoxic respiratory failure treated with iNO, however the lack of predefined selection criteria for TH use, the retrospective nature of the study and the small number of patients make it difficult to generate a firm hypothesis.
Funding
Supported by the 2025-2.1.1-EKÖP-2025-00014 University Research Scholarship Programme of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.