• Tais F Galvao, Marcus T Silva, Mariana C Marques, Nelson D de Oliveira, and Mauricio G Pereira.
• University of Brasilia, Faculty of Medicine, Brasilia, Distrito Federal, 70910-900, Brazil.
• J. Trop. Pediatr. 2013 Dec 1; 59 (6): 453-9.

ObjectiveTo assess the effect of hypothermia on mortality of neonates with hypoxic-ischemic encephalopathy in different economic resources settings.MethodsWe searched for randomized controlled trials on MEDLINE, Embase and other databases. Duplicate reviewers selected the studies and extracted data. We calculated meta-analyses of the relative risks (RR) and 95% confidence intervals (95% CI), and used meta-regression to evaluate the gross domestic product per capita influence on hypothermia efficacy.ResultsSixteen studies were included (n = 1889); eight were conducted in lower income countries (n = 662). Hypothermia significantly reduced mortality (RR = 0.77; 95% CI: 0.65-0.92). Meta-regression revealed that hypothermia efficacy does not increase as the gross domestic product per capita rises.ConclusionsThere is enough evidence to support hypothermia as the standard care for hypoxic-ischemic encephalopathy. Evidence from low-resource settings is limited, but hypothermia efficacy was not shown to be associated with better resources countries.

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