Hypothermia, associated factors and neonatal outcome

Abstract

Hypothermia in newborn babies is a problem in tropical countries despite warm environmental conditions and it contributes to neonatal morbidity and mortality.

This cohort study was done in the Neonatal Care unit, Muhimbili Medical Centre to determine the prevalence of hypothermia on admission, associated factors and neonatal outcome in terms of morbidity, weight loss, duration of stay in the neonatal unit and mortality. The study was conducted from July to October 1996 and the study population included all neonates admitted to the Neonatal Care Unit during the said period.

The prevalence of hypothermia on admission was found to be 22.4% and hypothermia was not recorded or reported to be a reason for admission in any of the neonates in this study, despite that 13.1% of the hypothermic neonates had severe hypothermia on admission. There was no low reading thermometer in the unit.

Hypothermia on admission was significantly associated with maternal intrapartum medications (P = 0.04), delivery by doctor (P = 0.000), delivery at Muhimbili Medical Centre Obstetrics Theatre (P = 0.000) or delivery in other hospitals(p = 0.00) , delivery by lower segment Caesarian section (P = 0.000) or by low cavity vaccum extraction (P = 0.01), low birth weight (P = 0.002), prematurity (P = 0.001), longer duration of transfer from place of delivery to the Neonatal Care Unit (P = 0.000) and inadequate clothing ofthe baby after delivery (P = 0.000). It was also

iii found that hypothermic neonates stayed longer in the Neonatal Care Unit than normothermic ones, they had more postnatal weight loss and increased risk of both morbidity and mortality. It is concluded that hypothermia is a problem in the Neonatal Care Unit, Muhimbili Medical Centre and is associated with increased morbidity and mortality. Efforts should be made to raise awareness among health providers with more emphasis on prevention. Daily use of low reading mercury thermometers is recommended in order to detect severe forms of hypothermia that require more aggressive management.