Neonatal hypothermia and associated factors in a special care baby unit

Abstract

INTRODUCTION: Neonatal hypothermia is known to result in many adverse consequences. Aims: To estimate the incidence and associated factors of neonatal hypothermia METHODS: This cohort study followed up 125 neonates consecutively admitted to Special Care Baby Unit of Teaching Hospital, Peradeniya from November 2011 to January 2012. A paediatric registrar interviewed parents using a structured-questionnaire and direct observation using a check list. On admission, axillary body temperature was measured and graded using WHO classification. Results: Of the 125 neonates, 96 were admitted within first day of birth (78.6%) and 72 had low birth weight (57.6%). Neonates were admitted from operation theater (58, 46.4%), postnatal ward (34, 27.2%) and labour room (23, 18.4%). Median temperature on admission was 36.2 °C with 38.4% having moderate hypothermia (n=48), 19.2% cold-stress (n=24) and none with severe hypothermia. Risk of hypothermia was increased by prematurity (OR = 9.9, 95% CI: 4.2 - 23), low birth weight (OR= 6.8, 3.1 -15.1), being delivered by caesa-pean section (OR=4, 1.8 - 9.1), admission from operation theatre or labour room (OR =9.1, 3.9 - 21.4) and cold delivery room ( p < 0.001). Caesarean rate was higher among neonates admitted to PBU than all the children delivered (OR = 3.35, 2.2 - 5.1). Hypothermia increases risk of poor activity (OR =1.8, 1.4 - 2.4), poor feeding (OR= 7.2, 1.5 - 34.9), poor cry (OR = 1.9, 1.5 - 2.4), respiratory distress (OR= 1.5, 1.1 - 2.0) and hypoglycemia (OR = 1.6, 1.2 - 2.0).