Date Published: June 6, 2019
Publisher: Public Library of Science
Author(s): Gebresilasea Gendisha Ukke, Ketema Diriba, Beena Kamath-Rayne.
Neonatal hypothermia is one of the main underlying factors associated with neonatal deaths.
The objective of this study was to assess the prevalence and factors associated with neonatal hypothermia on admission to neonatal intensive care units in Southwest Ethiopia.
Institution-based cross-sectional study design was employed between February to September 2017 at intensive care units of Arba Minch and Jinka General Hospitals. All neonates admitted to the two neonatal intensive care units during the study period were included in the study. Data were collected by four nurses who were working in the units of the hospitals through semi-structured pre-tested questionnaire and checklist. Multi-variable logistic regression was used to analyze the relationship between the dependent and independent variables using odds ratio with a confidence interval of 95% and a p-value of 0.05.
The prevalence of neonatal hypothermia on admission to the neonatal intensive care units in this study area was 50.3%. Admission weight below 2500 gm. (AOR = 3.61, 95% CI: 2.10, 6.18), delay in initiation of breastfeeding (AOR = 2.42, 95% CI: 1.45, 4.02), early bathing (AOR = 2.63, 95% CI: 1.23, 5.63), admissions during cold season (AOR = 1.72, 95% CI: 1.04, 2.84), and presence of obstetrical complication(s) during pregnancy/labor (AOR = 2.46, 95% CI: 1.07, 5.66) were factors significantly associated with hypothermia on admission to the neonatal intensive care units.
The prevalence of neonatal hypothermia on admission to the intensive care units was high. There is a need to create awareness among the community members about the dangers of early bathing and late initiation of breastfeeding. It is also important to give attention to the newborns of mothers with obstetric complications, low-birth-weight babies and babies delivered during the cold season.
The first few minutes afterbirth are the most important time for infant survival as it is the transitional period from intrauterine to extra-uterine life where different adaptations take place. The sudden change in the ambient temperature of the newborns during delivery, especially in the absence of appropriate preventive measures can lead to neonatal hypothermia, defined by the World Health Organization as an axillary temperature of less than 36.5oc (97.7°F) [1, 2].
In this study, one out of two neonates was hypothermic on admission to the NICUs. This finding is in line with the findings from a study conducted in Brazil between 2010 and 2012 where the prevalence of neonatal hypothermia on admission to NICU was 51%. However, it is lower than the results from studies conducted in Nigeria between 2007 and 2008 where the prevalence of neonatal hypothermia on admission to NICU was 62%, a Zimbabwe study in which it was 85% and a study conducted in Ethiopia where the proportion of the neonates with hypothermia at the time of admission to NICU was 64%. The possible reason that the figure is relatively lower than the findings of most the previous studies could be the location of the hospitals as both are in hot climatic zones [10, 11, 15, 19].
The prevalence of neonatal hypothermia on admission to these two Ethiopian NICUs was high. Delay in initiation of breastfeeding, giving bath within 24 hours of birth, the presence of obstetric problems during pregnancy and/or labor, weight of the neonate less than 2500 gm., and admissions during the cold season were factors significantly associated with neonatal hypothermia on admission to NICUs.