Impact of temperature change from admission to day one on neonatal mortality in a low-resource setting
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(2020) 20:646
RESEARCH ARTICLE
Open Access
Impact of temperature change from admission to day one on neonatal mortality in a low-resource setting Francesco Cavallin1, Serena Calgaro2,3, Valentina Brugnolaro3, Amir Hussein Abubacar Seni4, Arlindo Rosario Muhelo4, Liviana Da Dalt3, Giovanni Putoto2 and Daniele Trevisanuto3*
Abstract Background: Thermal control after birth is an essential part of neonatal care. However, the relationship between neonatal temperature at and after admission is unknown. This study aimed to evaluate the change between neonatal temperature at admission and at day 1, and its impact on mortality. Methods: Retrospective observational study at the Beira Central Hospital, Mozambique. Axillary temperatures were recorded at admission and at day 1 in 1,226 neonates who were admitted to the Special Care Unit between January 1 and December 31, 2017. The relationship between mortality rate and temperature change was evaluated with a matrix plot and a forest plot (obtained from a logistic regression model as odds ratios with 95% confidence intervals). Results: Normothermia was found in 415 neonates (33.8%) at admission and in 638 neonates (52.0%) at day 1. Mortality rate was highest in (i) neonates who remained in severe/moderate hypothermia (74%), (ii) neonates who rewarmed from hypothermia (40–55%), and (iii) neonates who chilled to severe/moderate hypothermia (38–43%). Multivariable analysis confirmed that temperature change from admission to day 1 was an independent predictor of mortality (p < 0.0001). Conclusions: In a low-resource setting, one out of three neonates was found hypothermic at day 1 irrespectively of admission temperature. Relevant thermal deviations occurred in a high proportion of newborns with normothermia at admission. Being cold at admission and becoming cold or hyperthermic at day 1 were associated with increased likelihood of mortality. Appropriate actions to prevent both hypothermia and hyperthermia represent both a challenge and a priority during postnatal period. Keywords: Birth, Hypothermia, Low-resource setting, Mortality, Temperature
* Correspondence: [email protected] 3 Department of Women and Children Health, University of Padova, Via Giustiniani, 3, 35128 Padova, Italy Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will
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