A retrospective data analysis on prevalence and risk factors for hypothermia among sick neonates at presentation to the neonatal intensive care unit of the Tamale Teaching Hospital

• Published in: PloS one Vol. 19; no. 5; p. e0303159
• Main Authors: Abdul-Mumin, Alhassan, Boi-Dsane, Naa Adzoa Adzeley, Oladokun, Samuel Tomilola, Owusu, Sheila Agyeiwaa, Ansah, Patrick
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 16-05-2024; Public Library of Science (PLoS)
• Subjects: Apgar score; Asphyxia; Asphyxia Neonatorum - epidemiology; Biology and Life Sciences; Birth weight; Births; Breastfeeding & lactation; Cesarean section; Data analysis; Data collection; Dry season; Ethiopia; Female; Gestational age; Ghana; Health aspects; Hospitals; Hospitals, Teaching; Humans; Hypothermia; Hypothermia - epidemiology; Infant, Low Birth Weight; Infant, Newborn; Infants (Newborn); Intensive care; Intensive care units; Intensive Care Units, Neonatal; Kenya - epidemiology; Low birth weight; Male; Maternal health services; Meconium; Meconium Aspiration Syndrome - epidemiology; Medicine and Health Sciences; Mortality; Neonatal care; Neonatal intensive care; Neonates; Newborn babies; Prevalence; Rainy season; Regression analysis; Retrospective Studies; Risk Factors; Subgroups; Teaching hospitals; Temperature; Variables; Kenya; Ghana; Ethiopia; Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0303159

Neonatal hypothermia, defined as an axillary temperature of <36.5C in a neonate, is common in neonatal intensive care units and is almost universal across all geographic and climatic regions of the world. This is even though environmental temperature is a known risk factor for its occurrence. We conducted a retrospective study in the Neonatal Intensive Care Unit of the Tamale Teaching Hospital (TTH) to document the prevalence and risk factors associated with hypothermia at presentation to the hospital. The study spanned the period from January 2019 to December 2019 and involved all neonates with axillary temperature documented at the time of admission. The prevalence of neonatal hypothermia in this study was 54.76%. Hypothermia was most common in neonates diagnosed with meconium aspiration syndrome (87/105, 82.86%), prematurity and low birth weight (575/702, 81.91%), and birth asphyxia (347/445, 77.98%). Neonates who were delivered vaginally were less likely to develop hypothermia compared to those delivered via Cesarean section. Inborn neonates (delivered in TTH) were 3.2 times more likely to be hypothermic when compared to those who were delivered at home. Neonates with low birth weight and APGAR scores < 7 at 1 and 5 minutes were more likely to be hypothermic. The dry season was found to be protective against hypothermia when compared to the rainy season. The overall mortality rate was 13.68% and the mortality in the subgroup with hypothermia at presentation was 18.87%. Our study documented a high prevalence of hypothermia with higher rates in neonates requiring intervention at birth. It is therefore crucial for perinatal care providers to adhere to the warm chain precautions around the time of birth.