Cold injury in early infancy. Relationship between mortality and disseminated intravascular coagulation

Sixteen cases of neonatal cold injury, 5 of them fatal, were seen in the winter of 1974-75. The affected infants, who weighed from 2.5 to 3 kg, had developed symptoms when the ambient temperature was below 10 C. Few of them were referred as cases of hypthermia. Refusal to eat was the most common complaint and less often edema and/or apathy. No correlation was found between death and ethnic origin, sex, duration of illness or minimum temperature. Admission weight, however, tended to be lower in the infants who died. The consistent finding of thrombocytopenia and the suspected bleeding phenomena suggested that disseminated intravascular coagulation may have been a factor in the unfavorable outcome of some of the cases. Evidence supporting such a hypothesis and proposals for the prevention, diagnosis and treatment of neonatal cold injury are presented.