Point-of-admission hypothermia among high-risk Nigerian newborns

BACKGROUND Facilities which manage high-risk babies should frequently assess the burden of hypothermia and strive to reduce the incidence. OBJECTIVE To determine the incidence and outcome of point-of-admission hypothermia among hospitalized babies. METHODS The axillary temperatures of consecutive admissions into a Nigerian Newborn Unit were recorded. Temperature <36.5 degrees C defined hypothermia. The biodata and outcome of these babies were studied. RESULTS Of 150 babies aged 0 to 648 hours, 93 had hypothermia with an incidence of 62%. Mild and moderate hypothermia accounted for 47.3% and 52.7% respectively. The incidence of hypothermia was highest (72.4%) among babies aged less than 24 hours. It was also higher among out-born babies compared to in-born babies (64.4% vs 58.3%). Preterm babies had significantly higher incidence of hypothermia (82.5%) compared with 54.5% of term babies (RR = 1.51; CI = 1.21 - 1.89). The incidence of hypothermia was also highest (93.3%) among very-low-birth-weight babies. The Case-Fatality-Rate was significantly higher among hypothermic babies (37.6% vs 16.7%; RR = 2.26, CI = 1.14 - 4.48) and among out-born hypothermic babies (50% vs 17.1%; RR = 0.34, CI = 0.16 - 0.74). CFR was highest among hypothermic babies with severe respiratory distress, sepsis, preterm birth and asphyxia. CONCLUSION The high incidence and poor outcome of hypothermia among high-risk babies is important. The use of the 'warm chain' and skin-to-skin contact between mother and her infant into routine delivery services in health facilities and at home may be useful.