Neonatal hypothermia and associated risk factors among newborns of southern Nepal
Open Access
- 8 July 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Medicine
- Vol. 8 (1), 43
- https://doi.org/10.1186/1741-7015-8-43
Abstract
Neonatal hypothermia is associated with an increased mortality risk for 28 days. There are few community-based data on specific risk factors for neonatal hypothermia. Estimates of association between neonatal hypothermia in the community and risk factors are needed to guide the design of interventions to reduce exposure. A cohort of 23,240 babies in rural southern Nepal was visited at home by field workers who measured axillary temperatures for 28 days (213,316 temperature measurements). The cumulative incidence of hypothermia (defined as < 35.0°C based on an analysis of the hypothermia-mortality risk relationship) was examined for any association with infant characteristics, care practices and parental, household, socioeconomic and demographic factors. Estimates were adjusted for age and ambient temperature. Ten percent of the babies (n = 2342) were observed with temperatures of < 35.0°C. Adjusted prevalence ratios (Adj PR) were increased among those who weighed < 2000 g [Adj PR = 4.32 (3.73, 5.00)] or < 1500 g [Adj PR = 11.63 (8.10, 16.70)] compared to those of normal weight (> 2500 g). Risk varied inversely along the entire weight spectrum: for every 100 g decrement hypothermia risk increased by 7.4%, 13.5% and 31.3%% for babies between 3000 g and 2500 g, 2500 g and 2000 g and < 2000 g, respectively. Preterm babies (< 34 weeks), females, those who had been first breastfed after 24 h and those with hypothermic mothers were at an increased risk. In the hot season the risk disparity between smaller and larger babies increased. Hypothermia was not associated with delayed bathing, hat wearing, room warming or skin-to-skin contact: they may have been practiced reactively and thereby obscured any potential benefit. In addition to season in which the babies were born, weight is an important risk factor for hypothermia. Smaller babies are at higher relative risk of hypothermia during the warm period and do not receive the protective seasonal benefit apparent among larger babies. The need for year-round thermal care, early breastfeeding and maternal thermal care should be emphasized. Further work is needed to quantify the benefits of other simple neonatal thermal care practices.Keywords
This publication has 33 references indexed in Scilit:
- Point-of-admission hypothermia among high-risk Nigerian newbornsBMC Pediatrics, 2008
- Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India: a cluster-randomised controlled trialThe Lancet, 2008
- Comparison of Neonates Born Outside and Inside Hospitals in a Children Emergency Unit, Southwest of NigeriaPediatric Emergency Care, 2008
- Community-Based Kangaroo Mother Care to Prevent Neonatal and Infant Mortality: A Randomized, Controlled Cluster TrialPEDIATRICS, 2008
- TRANSEPIDERMAL WATER LOSS IN NEWBORN INFANTSActa Paediatrica, 2008
- Impact of Newborn Skin-Cleansing With Chlorhexidine on Neonatal Mortality in Southern Nepal: A Community-Based, Cluster-Randomized TrialPEDIATRICS, 2007
- Introduction of community-based skin-to-skin care in rural Uttar Pradesh, IndiaJournal of Perinatology, 2006
- Delayed Breastfeeding Initiation Increases Risk of Neonatal MortalityPEDIATRICS, 2006
- The Incidence of Morbidities in a Cohort of Neonates in Rural Gadchiroli, India: Seasonal and Temporal Variation and a Hypothesis About PreventionJournal of Perinatology, 2005
- A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for HeteroskedasticityEconometrica, 1980