Background and Aims To compare anapyrexia (a physiological decrease in body temperature in neonates in response to hypoxia) with normothermia (conventional management) with respect to immediate outcome and neuro-developmental outcome at 3 and 6 months of age in full term asphyxiated newborns.

Methods Fifty full term intramural neonates with severe birth asphyxia were randomized to Study (Anapyrexia) group and Control (Normothermia) group. Neonates in Anapyrexia group were allowed to remain at their own intrinsic temperature for a period of 72 hours. Neonates randomized to the Normothermia group had their temperature maintained between 36.5⁰C to 37.5⁰C with assistance from the servocontrolled radiant warmer. All neonates were managed according to standard management protocol of the unit. The subjects were monitored closely for any adverse effects, seizures, and development of HIE. The neurological examination was done at 6 hourly interval for the first 24 hours and then at 12 hourly interval. The surviving neonates were followed up at 3 months and 6 months of age.

Results The development of HIE stage 3 was significantly lower in Anapyrexia group(8%) than in the Normothermia group(28%)(p=0.032; [RR]=0.285). Fifteen neonates in the anapyrexia group had normal outcome versus only 9 in the normothermia group(p=0.049,[RR]=0.5). The incidence of mortality(12% vs 16%,p=0.264,[RR]=0.75) complications and baseline characteristics were comparable.

Conclusions Anapyrexia if allowed to persist for 72 hours after birth, alleviates the ill effects of hypoxic ischemic insult and results in improved outcome in the neonates particularly the neuro-developmental outcome at 6 months of age.