The Effect of Admission Hypothermia on Newborn

Author(s): Ali Almudeer*, Muneerah Najmi, Easa Magfori, Mohammed Salawi

Objective: Consequences of hypothermia is associated with higher mortality and morbidity therefore, thermal control following delivery is an essential of neonatal care. We decided to learn more about thermal regulating procedures in our unit. The goal of this study was to determine the temperature at the time of admission to our neonatal intensive care units (NICUs) and how it relates to death and other morbidity. We also interested to look into the newborn interventions after delivery to control temperature and see how these interventions affect thermal regulation.

Methods: Prospective cohort study using perinatal chart review data for all babies admitted to the NICU at King Fahd central hospital in Jazan. 300 babies through period of April 2021 to March 2022. Hypothermia was classified according to WHO definition as mild (36–36.5°C), moderate (32–35.9°C), or severe (32°C) when the temperature dropped below 36.5°C. We used a multivariable logistic regression analysis to investigate the adjusted effect of hypothermia on neonatal mortality and complications The regression analysis results were provided as crude/unadjusted odds ratios (OR) and adjusted odds ratios (AOR) with 95% confidence intervals (CIs).

Results: Of the infants included in the dataset Almost half of them (49.3%) had abnormal body temperature, 20.7%, 11.3%, and 17.3% had mild, moderate, and severe hypothermia respectively. Around 20% of newborns were given a bath 2 hours after birth, 36% their head covered with hats, and 21.7% had skin-to-skin contact. The adjusted model found that newborns with severe hypothermia were 0.53 (OR = 0.53; [95% CI: 0.15-1.83]) times likely to die and 2.04 (OR = 2.04; [95% CI: 0.76-5.46]) times likely to develop any complication when compared to newborns without hypothermia. Newborns with low birth weight (OR = 16.5; [95% CI: 1.47-185.7]) and without skin-to-skin contact (OR = 3.27; [95% CI: 1.33-8.04]) were more likely to develop any complication when compared to those with skin-to-skin contact.

Conclusion: Hypothermia, low birth weight, abnormal CBC, and absence of skin-to-skin contact all raise the risk of neonatal morbidity, according to this study. According to the study, thermal regulation techniques such as head coverings, skin-to-skin contact, and delayed bathing are not widespread in Saudi Arabian hospitals. These findings call for a review of the procedures or recommendations, as well as an assessment of how well the thermal regulation rules are being followed in NICUs.