Hypothermia of newborns is associated with excess mortality in the first 2 months of life in Guinea-Bissau, West Africa

Autor: Jens Nielsen, Peter Aaby, Sidu Biai, Marianne Skytte Jakobsen, Jens Erik Veirum, Morten Sodemann
Rok vydání: 2008
Předmět:
Zdroj: Sodemann, M, Nielsen, J, Veirum, J, Jakobsen, M S, Biai, S & Aaby, P 2008, ' Hypothermia of newborns is associated with excess mortality in the first 2 months of life in Guinea-Bissau, West Africa ', Tropical Medicine & International Health, vol. 13, no. 8, pp. 980-6 . https://doi.org/10.1111/j.1365-3156.2008.02113.x
ISSN: 1365-3156
1360-2276
Popis: Summary objective To examine the long-term effects of neonatal hypothermia (HT) on survival.methods Using the longitudinal community and hospital surveillance system of the Bandim HealthProject, we followed children born between 1997 and 2002 at the only maternity ward in the city. Allchildren’s axillary temperature was measured within 12 h of birth. They were followed from birth to6 months of life through regular home visits.results We identified 2926 live births in the study area and 177 deaths before 6 months of age. Basedon mortality risk, we defined a temperature below 34.5 C as the cut-off point for HT. Two hundred andthirty-eight (8%) children had HT. Controlled for birth weight, HT was associated with a nearly fivefoldincrease in mortality during the first 7 days of life [mortality ratio (MR) = 4.81 (2.90–8.00)] and withincreased mortality from 8 to 56 days of life [MR = 2.55 (1.29–5.04)].conclusion HT is associated with excess mortality beyond the perinatal period up to at least 2 monthsof age, especially among low-birth-weight children. Hence, failure to comply with the WHO guidelinesfor care of newborns in low-income countries may have long-term consequences for child survival whichhave not previously been assessed. The WHO definition of HT should be based on mortality data.keywords neonatal hypothermia, survival, neonatal mortality, birth weight, Guinea-BissauBackgroundIn developing countries, child mortality declined during the1980s, but neonatal mortality did not improve. Hypo-thermia (HT) in newborns is known to increase perinatalmortality among those born in hospital and those bornunattended at home (Costeloe et al. 2000; da Mota Silveiraet al. 2003; Kambarami & Chidede 2003; Manji K Li et al. 2004). In the majority of studies, a skintemperature of less than 36.0 C has been used as a cut-offfor HT (Christensson et al. 1993; Da Mota Silveira et al.2003).An incidence of HT of 67% among neonates bornoutside of hospital was found in Ethiopia, while theincidence in a Ugandan hospital was 79% and 85% inZimbabwe (Uxa 1994; Kambarami & Chidede 2003;Byaruhanga et al. 2005). A study from Tanzania found a22% prevalence of HT among newborns admitted to aneonatal care unit (NCU) and HT children had threefoldincreased mortality in the hospital compared with childrenwith a normal body temperature (Kambarami & Chidede2003; Manji & Kisenge 2003).A community study of neonatal morbidity from India inan area with 95% homebirths found a community HTincidence of 17% among sick neonates aged 1–28 days anda case fatality of HT of 5% (Bang et al. 2005b). But studiesof HT associated with mortality linking community andhospital data are very limited and to our knowledge there isno community study investigating longer term survival ofnewborns who develop HT within the first hours of life.
Databáze: OpenAIRE
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