Work

Hypothermia—Prevalence and risk factors in neonates admitted to a neonatal unit in Tanzania

Year: 2024

Type: article

Abstract: AIM: We aimed to study the prevalence of hypothermia among neonates, the association between admission temperature and neonatal mortality, and the impact of radiant warmers. METHODS: In an observational prospective study, we included 1988 neonates born at Haydom Lutheran Hospital, Tanzania, and admitted to the neonatal unit from 1 January 2018 to 31 December 2022. We explored risk factors for hypothermia (<36.0°C, primary outcome) and newborn mortality by admission temperature (secondary outcome) with adjusted odds ratios (aOR) and 95% confidence intervals (CI) for birth weight and bag and mask ventilation. RESULTS: Hypothermia was present in 47.0% (n = 935) at admission, 46.9% (n = 932) were normothermic or mildly hypothermic (36.0-37.5°C), and 6.1% (n = 121) hyperthermic. Of those admitted to the neonatal unit, 217 (10.9%) died. For every 1°C increase in temperature, neonatal mortality decreased by 31% (aOR 0.69, 95% CI 0.59-0.82). Admission temperature <34.5°C was strongly associated with mortality (aOR 3.56, 1.87-6.79). Mild hypothermia (36.0-36.5°C) was not associated with mortality (aOR 1.30, 0.72-2.37). Risk factors for hypothermia were bag and mask ventilation (aOR 2.53, 2.07-3.11) and low birth weight. The introduction of radiant warmers from 1 May 2022 was associated with a decrease in hypothermia (aOR 0.54, 0.41-0.72). CONCLUSION: Hypothermia is prevalent even in tropical settings and maintaining normothermia after birth is critical and achievable for reducing neonatal mortality.

Source: Acta Paediatrica

DOI: 10.1111/apa.17499