Abstract

TSHEHLA, R M; COETZEE, M  and  BECKER, J. The impact of hypothermia in a tertiary hospital neonatal unit. S. Afr. j. child health [online]. 2023, vol.17, n.4, pp.201-206. ISSN 1999-7671.  http://dx.doi.org/10.7196/SAJCH.2023.v17i4.1922.

BACKGROUND: Neonatal hypothermia, defined as a body temperature <36.5°C, is a known contributor to neonatal morbidity and mortality. The admission temperature is an important predictor of neonatal outcomes, and a measure of quality of care. OBJECTIVES: This study aims to determine the incidence of and factors associated with hypothermia on admission to the neonatal unit at Steve Biko Academic Hospital (SBAH), a public tertiary hospital in South Africa. METHODS: A retrospective, cross-sectional study of infants admitted to the neonatal unit from September 2019 to February 2020 using data from patient records. RESULTS: The overall incidence of hypothermia on admission was 66% (mild 25%, moderate to severe 41%), with a mean (standard deviation (SD)) admission temperature of 35.1 (4.7)°C, and 82% (mild 19%, moderate to severe 62%) in very-low-birthweight infants. Infants remained hypothermic for a mean (SD) of 4.1 (3.9) hours post admission. Birthweight <1 500 g (odds ratio (OR) 1.87; p=0.019), admission to the neonatal intensive care unit (OR 1.97; p<0.0001), and admission from the delivery room within the first 60 minutes of life (OR 3.06; p=0.026) were independent risk factors for hypothermia. Hypothermia was associated with increased duration of respiratory support (mean 3.2 (5.6) v. 1.7 (4.5) days; p<0.0001), and longer length of hospital stay (mean 17.9 (18.8) v. 10.9 (12.6) days; p<0.0001). CONCLUSION: The incidence of hypothermia on admission to the unit is significantly high, and hypothermic infants take a significant length of time to regain normothermia. A standardised protocol for the prevention and management of hypothermia needs to be introduced in the unit.

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