A study conducted at the University of Gondar Comprehensive Specialized Hospital has highlighted the significant prevalence of neonatal hypothermia, with findings indicating a staggering 70.5% of admitted neonates at risk. Neonatal hypothermia, defined as a core body temperature below 36.5˚C, poses serious threats to infant health, contributing significantly to neonatal morbidity and mortality.
The necessity of this study is underscored by the World Health Organization’s guidelines, which recognize adequate thermal protection as fundamental to newborn care. Researchers aimed to identify the major contributors to this condition, which could inform interventions for its prevention.
Over the study period, spanning from March to August 2023, 339 neonates were systematically sampled upon admission to the neonatal intensive care unit (NICU). The study utilized both bivariate and multivariate logistic regression analyses to pinpoint significant risk factors associated with hypothermia, settling on thresholds for statistical significance at p < 0.05.
Significantly associated factors identified included low birth weight, cesarean delivery, and the timing of bathing following birth. Specifically, neonates with birth weights below 2500 grams were found to be 8.35 times more likely to experience hypothermia, emphasizing the heightened vulnerability of low birth weight infants due to inefficient thermoregulation mechanisms.
"Neonates born during nighttime were 3 times more likely to develop neonatal hypothermia,” the researchers reported, linking this to the lower temperatures typically experienced during nocturnal deliveries.
Another alarming statistic revealed was the risk associated with bathing practices; newborns bathed within 24 hours of birth faced risks nearly four times higher for developing hypothermia compared to those who were not bathed early. This finding highlights the importance of delaying bathing to maintain body heat and support thermoregulation.
Clothing and head coverings also emerged as significant factors. Newborns lacking adequate clothing or head coverage, typically identified as being poorly clothed, exhibited arbitrary increased odds of developing hypothermia. This aspect emphasized the necessity of proper thermal care immediately postpartum.
The location of delivery was another cornerstone of the findings. Those delivered outside designated health facilities faced nearly 7 times the likelihood of hypothermia upon hospital admission, indicating potential gaps in neonatal care practices during home births.
Finally, the study observed variations by birth method; cesarean sections were associated with increased hypothermia prevalence, attributing this to possible complications and inadequate thermal care during transport from the delivery room to the NICU.
The conclusion drawn from this thorough investigation points to the urgent need for stricter adherence to the WHO’s warm chain protocols, including immediate skin-to-skin contact, proper drying and wrapping of newborns, and the promotion of early breastfeeding. Understanding and implementing these factors could drastically reduce neonatal hypothermia rates and improve overall outcomes for vulnerable populations.
Given the high prevalence of neonatal hypothermia identified, the authors urge hospitals to prioritize infection control and thermal care education among healthcare providers. Future studies are also recommended to explore qualitative factors influencing healthcare practices concerning neonatal hypothermia.