Hypothermia-Prevalence and risk factors in neonates admitted to a neonatal unit in Tanzania.

Autor: Braa HG; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Mathisen EA; Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Moshiro R; Muhimbili National Hospital, Dar es Salaam, Tanzania., Daudi VX; Haydom Lutheran Hospital, Manyara, Tanzania., Francis F; Haydom Lutheran Hospital, Manyara, Tanzania., Mduma E; Haydom Global Research Centre, Manyara, Tanzania., Ersdal H; Stavanger University Hospital, Stavanger, Norway., Størdal K; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.; Department of Paediatric Research, Oslo University Hospital, Oslo, Norway.
Jazyk: angličtina
Zdroj: Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2024 Nov 15. Date of Electronic Publication: 2024 Nov 15.
DOI: 10.1111/apa.17499
Abstrakt: Aim: We aimed to study the prevalence of hpyothermia among neonates, the association between admission temperature and neonatal mortality, and the impact of radiant warmers.
Methods: In an observational prospective study, we included 1988 neonates born at Haydom Lutheran Hospital, Tanzania, and admitted to the neonatal unit from 1 January 2018 to 31 December 2022. We explored risk factors for hypothermia (<36.0°C, primary outcome) and newborn mortality by admission temperature (secondary outcome) with adjusted odds ratios (aOR) and 95% confidence intervals (CI) for birth weight and bag and mask ventilation.
Results: Hypothermia was present in 47.0% (n = 935) at admission, 46.9% (n = 932) were normothermic or mildly hypothermic (36.0-37.5°C), and 6.1% (n = 121) hyperthermic. Of those admitted to the neonatal unit, 217 (10.9%) died. For every 1°C increase in temperature, neonatal mortality decreased by 31% (aOR 0.69, 95% CI 0.59-0.82). Admission temperature <34.5°C was strongly associated with mortality (aOR 3.56, 1.87-6.79). Mild hypothermia (36.0-36.5°C) was not associated with mortality (aOR 1.30, 0.72-2.37). Risk factors for hypothermia were bag and mask ventilation (aOR 2.53, 2.07-3.11) and low birth weight. The introduction of radiant warmers from 1 May 2022 was associated with a decrease in hypothermia (aOR 0.54, 0.41-0.72).
Conclusion: Hypothermia is prevalent even in tropical settings and maintaining normothermia after birth is critical and achievable for reducing neonatal mortality.
(© 2024 The Author(s). Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)
Databáze: MEDLINE
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