Hypothermia on admission and its association with neonatal mortality and morbidity in neonatal intensive care unit.

BACKGROUND: Neonatal hypothermia is a drop in the newborn's core temperature less than 36.5°C. It is crucial in neonatal morbidity and mortality, particularly in preterm infants. This research aimed to assess the incidence and risk factors of neonatal hypothermia and its effect on neonatal mortality and short-term morbidity during Neonatal Intensive Care Unit (NICU) admission.

METHODS: This observational study was conducted on all neonates admitted to the NICU at Benha University Hospital. The core temperature was measured on admission for all admitted neonates and were followed up to assess the impact of hypothermia on short-term outcomes and mortality.

RESULTS: A total of 323 neonates were admitted to the NICU throughout the research period. Thirty-five cases were excluded due to congenital anomalies or missing or late admission temperature recordings. The study included 288 neonates whose mean gestational age was 34.6±3.4 weeks, and their mean birth weight was 2.35±0.9 kg. Two-thirds (66%) of the neonates had core temperatures indicating hypothermia (axillary temperature of less than 36.5°C), one-third (33%) were normothermic, and only three (1%) were hyperthermic. Neonates with hypothermia had statistically lower gestational age, higher frequency of multiple births, prolonged need for respiratory support, higher rates of pulmonary hemorrhage, sepsis, intraventricular hemorrhage (IVH), and necrotizing enterocolitis, longer hospital stay, and mortality.

CONCLUSIONS: There is a high incidence of neonatal hypothermia at NICU admission. Lower gestational age, increased multiples, lower APGAR score, lower birth weight, and lack of antenatal steroids were significantly associated with hypothermia at NICU admission. Hypothermia was found to be a significant factor contributing to increased mortality and morbidity rates in affected neonates.