Table 1

Global epidemiology of newborn hypothermia

Reference

Location

Setting

N

Case definition body temp

Temperature measurements

Hypothermia prevalence

Additional findings


Africa

Hospital based:

[28]

Sagamu, Nigeria

University Hospital

150

< 36.5°C

Axillary upon admission

62%

Hypothermia risk highest in the first 24 h of life in preterm babies

[75]

Sagamu, Nigeria

University Hospital

111

< 36.5°C

Axillary upon admission

68%

Hypothermia risk highest in low birth weight babies and those who were not breastfed

[76]

Ibadan, Nigeria

University Hospital

541

< 35.0°C

N/A

45%

Hypothermia more prevalent on admission in infants born outside the hospital than those born at the hospital

[35]

Guinea-Bissau

National Hospital

2,926

< 34.5°C

Axillary within 12 h of birth

8%

Hypothermia of < 34.5°C associated with mortality risk of 4.81 (95% CI 2.90 to 8.00) in first 7 days compared to those without hypothermia

[29]

Kampala, Uganda

Periurban Hospital

300

< 36.5°C

Rectal and tympanic four times within 90 minutes postpartum

79%

Hypothermia incidence increased from 29% at 10 minutes postpartum to 79% at 90 minutes postpartum

[47]

Kampala, Uganda

Periurban Hospital

249

< 36.5°C

Rectal 60 minutes postpartum

46%

Early bathing increased the risk of hypothermia in spite of use of warm water and skin-to-skin care

[25]

Lusaka, Zambia

University Hospital

62

< 36.0°C

Rectal 30 and 120 minutes after delivery

53% and 69%

At discharge after an average of 14 h, hypothermia was still persistent in half of all babies sampled

[26]

Lusaka, Zambia

University Hospital

261

< 36.0°C

Rectal upon admission

44%

Mortality was higher in hypothermic infants than in those who were not hypothermic

[77]

Harare, Zimbabwe

University Hospital

313

< 36.0°C

Axillary

51.4%

[59]

Harare, Zimbabwe

University Hospital

313

< 36.0°C

Axillary upon admission

85%

[27]

Ethiopia

Hospital

< 36.0°C

N/A

53%

Asia

Hospital based:

[78]

Iran, different provinces

University Hospitals

1,952

< 36.0°C

Rectal after delivery and four repeats within 6 h of admission to neonatal unit

33.8%

Newborn with low birth weight, prematurity, low Apgar scores, of multiple pregnancies and after cardiopulmonary resuscitation at higher risk for being hypothermic in regression analysis. Hypothermia is associated with an increased risk of neonatal mortality risk (OR = 3.1, 95% CI 1.9 to 5.2) as well as risk of metabolic acidosis, jaundice, respiratory distress, hypoglycemia, and pulmonary hemorrhage.

[33]

Tehran, Iran

University Hospitals

940

< 36.5°C

Rectal upon admission to neonatal unit (mean time after delivery 20 minutes)

53.5%

Hypothermia at birth is associated with an increased neonatal mortality risk (OR = 3.64, 95% CI 1.85 to 7.18), as well as risk for respiratory distress (OR = 2.12, 95% CI 1.53 to 2.93), metabolic acidosis (OR = 2.83, 95% CI 1.74 to 4.59), and jaundice (OR = 2.01, 95% CI 1.45 to 2.79), controlling for weight and gestational age

[32]

Tehran, Iran

University Hospital

900

< 36.5°C

Rectal after delivery and four repeats within 6 h of admission to neonatal unit

53.3%

Low birth weight, low gestational, age environmental temperature, low Apgar score, multiple pregnancy and receiving cardiopulmonary resuscitation increased risk for being hypothermic in regression analysis

[79]

Hangzhou, China

University Hospital

200

< 36.5°C

Axillary after delivery and five times on first, second and third day

52%

Hypothermia risk associated with low birth weight and gestational age

[40]

Kathmandu, Nepal

Maternity Hospital

495

< 36.0°C

Rectal 2 h after delivery

85%

[80]

Kathmandu, Nepal

Maternity Hospital

82

< 35.0°C

Rectal after delivery

26%

[60]

Kathmandu, Nepal

Maternity Hospital

100

< 36.0°C

Rectal after delivery

64%

16% of hypothermic infants died within first week of life

[81]

Kathmandu, Nepal

Maternity Hospital

76

< 36.0°C

Axillary after delivery

63%

[82]

Kathmandu, Nepal

Maternity Hospital

35

< 36.0°C

Continuous axillary and forehead skin probe

72% (Incidence in percent of time being hypothermic from birth to 8 h of life)

[83]

Mumbai, India

Hospital

206

N/A

N/A

37%

Prevalence 5.9% in infants with kangaroo mother care

Asia

Community based:

[19]

Kathmandu, Nepal

Community

12

< 35.0°C

Rectal within 12 h after delivery

91%

[84]

Kathmandu, Nepal

Community

250

< 36.0°C

Axillary

82%

[20]

Haryana, India

Community

189

< 35.6°C

Axillary once on first day

11%

Higher prevalence in winter (19%) than in summer (3%); in a secondary analysis applying a case definition of 36.5°C, prevalence was 38%; correlation between room air temperature and body temperature

[21]

Gadchiroli

Community

763

< 35.0°C

Axillary on 8 days during first month

17%

Higher prevalence in winter than in summer

[22]

Uttar Pradesh, India

Community

1,732

< 36.5°C

Axillary 3 to 36 h after birth

43%

Body temperature lower in low ambient temp < 20°C and in newborns with hypothermic mothers

[85]

Dehli, India

Community

32

< 35.0°C

Axillary daily on first 7 days of life

25%

[39]

Uttar Pradesh, India

Community

148

< 36.5°C

Axillary within 48 h and on days 7, 30 and 60

14%

[16]

Sarlahi, Nepal

Community

23,240

< 36.5°C

Axillary on 10 days during first month

92.3%

Hypothermia risk highest in the first 72 h of life

[17]

Sarlahi, Nepal

Community

23,240

< 36.5°C

Axillary on 10 days during first month

92.3%

Hypothermia risk highest in preterm babies, females, those breastfed later than 24 h after delivery, and those with hypothermic mothers

[18]

Sarlahi, Nepal

Community

23,240

< 36.5°C

Axillary on 10 days during first month

92.3%

Mortality risk increases by 80% for every 1°C decrease. Mortality risk 6.11 for newborns < 35.0°C compared to those > 36.5°C.

South America

Hospital based:

[34]

Recife, Brazil

University Hospital

320

< 36.5°C

Axillary on admission

32%

Hypothermia increased neonatal mortality risk, AOR = 3.49, 95% CI 3.18 to 3.81


Lunze et al. BMC Medicine 2013 11:24   doi:10.1186/1741-7015-11-24

Open Data