Prevalence and factors associated with neonatal hypothermia among deceased neonates after admission to neonatal intensive care unit at Butajira General Hospital, Ethiopia

Abstract

Introduction: Despite substantial progress, neonatal mortality remains high globally with sub-Saharan Africa and South Asia leading with the burden. In Ethiopia, neonatal hypothermia is implicated in up to 79.6% of neonatal deaths. This study aims to describe the magnitude of the history of hypothermia among neonates deceased at Butajira General Hospital neonatal intensive care unit.

Methods: The study is a hospital-based cross-sectional study conducted among 189 deceased neonates. Data was collected by retrospective chart review for those deceased during September 2020 to February 2021 and primary data was collected from care takers for neonates deceased between March 2021 to August 2022. Data were analyzed using SPSS version 28. Bivariate and multivariate logistic regression analyses were performed to assess the association between neonatal hypothermia and potential risk factors. The strength of association was measured using adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs).
Result: During the study period, a total of 189 neonates died, of which 109(57.7%) were male. At admission, 120(66.7%) of deceased neonates had respiratory distress syndrome and hypothermia was observed in 160(84.7%) of the cases. Low birth weight increased the odds of hypothermia by threefold (AOR = 3.25, 95% CI: 1.35–7.83). Preterm neonates had four times higher odds (AOR = 4.30, 95% CI: 1.73–10.69), while those admitted during the late neonatal period were 55% less likely to develop hypothermia (AOR = 0.47, 95% CI: 0.24–0.81).

Conclusion: Hypothermia is a major morbidity type among the deceased neonates where more than 80% of deceased neonates had history of hypothermia. Hypothermia is commonly identified among low birth weight neonates, preterm neonates, and those with younger age at admission to intensive care units. Implementing meticulous thermal care based on WHO’s warm chain principles, especially for high-risk neonates, may reduce neonatal mortality in similar low-resource settings.