Modifiable and Nonmodifiable Factors Contributing to Hypothermia Among High Risk Neonates at Admission to NICU—A Prospective Observational Study

Abstract

Background: Hypothermia is a well-known contributor to neonatal morbidity and mortality, especially for preterm and low-birth weight neonates. Identifying the predictors for admission hypothermia which are specific to the settings is important to initiate quality improvement projects and improve clinical outcomes. Methods: Study was conducted over a period of 6 months from 1 April to 31 September 2018. All inborn infants needing neonatal intensive care unit (NICU) admission were eligible for the study. The study involved measuring temperatures at exit from delivery room (DR) and at admission to NICU. Hypothermia was defined as core admission temperature <36.5°C. The data collected included all modifiable and nonmodifiable risk factors for hypothermia in newborns. Data was analyzed using logistic regression to determine associations, if any, between admission hypothermia and maternal, neonatal, and environmental characteristics. Results: One hundred and ninety-three infants were enrolled in the study. The incidence of admission hypothermia (<36.5°C) was 83.9%. Forty-four (22.8%) infants had mild hypothermia, 61.1% infants had moderate hypothermia, and none of the neonates had severe hypothermia. Nonmodifiable factors affecting admission temperature were birth weight/gestational age and mother’s temperature before shifting to DR. DR temperature strongly predicted the admission temperature and every 1°C increase in DR temperature improved the rate of admission hypothermia by 34%. Conclusion: Significant proportion of neonates is hypothermic at the time of admission to NICU. DR temperature significantly predicts hypothermia at admission in neonates needing NICU admission.