Magnitude &risk factors of neonatal hypothermiaon Admission, after 1& 6hoursin neonates admitted to jush Nicu

Abstract

Back ground:In both developed and developing countries, hypothermia is an important risk factor for morbidity and mortality in newborns especially in premature baby. According to WHO, Hypothermia is defined as axillary temperature <36.5ºC,However there are limited data available on the incidence of admission hypothermia &risk factors available in Ethiopia Objective: The aim of this study is to assessthe magnitude & risk factors of neonatal hypothermia on admission, after 1 hour & 6 hours of stay amongneonatesaged <72 hours on admission to JUSH NICU. Methods and Materials:A prospective longitudinal study design&Since our aim is to know the magnitude the sample size of 384 were determined by using single population proportion formula of calculating the minimum sample size, 95% CI.Assumption was also used. So according to this formula:- n=Z² p (1-p)/W²,so n=(1.96)²(0.5)(1-0.5)/(0.05)² were conducted to collectClinical Data & Information on the independent variables by using structured questionnairefrom neonates admitted to JUSH NICU from June 1, 2015- August 30, 2015G.Cby a trained two nursesand data was checked for completeness and consistency &Data analysis was done by using SPSS version20. The research undertaking was funded by Jimma University student research program.All newborns admitted to NICU during the study period, except those meet the exclusion criteria, were included in the study. Results: The Magnitudeofhypothermia on admission in this study was 75.1% which is one of the highest figures in the world&around 158/298(43.1%), & 50/298(16.8%) were remaining hypothermic at the 1st & 6th hours after admission, respectively,In the bivariable model, Independent variables like: Age on admission, Sex, GA, BW, 5TH minute APGAR- Score, number of towels, & maternal temperature have association butvariables like functioning radiant warmer in labor ward, resuscitation, mode of delivery, & type of towels (warm or not) have no effect in my study. However,Female sex, young age at admission, LBW, low 5th minute APGAR score &number of towel (1 towel)were the factors, continued to have statistically significant association with hypothermia (AOR= 3.85, 2.25, 2.58, .36, & 2.33; with 95% CI: 1.59, 9.32; 1.23, 4.13; 1.25, 5.34; .129, .99; 1.11, 4.89) respectively, in the multivariable logistic regression analysis during this study& ,therefore,Female sex, young age at admission, LBW, low 5th minute APGAR score &number of towel (1 towel) were the variables independently associated with the development of hypothermia according to this study. Conclusion: TheMagnitudeof hypothermia on admission in this study is significantly high. There was a statistically significant positive association between majorities of the independent variables with the presence of hypothermia. The fact that this temperature measurement was done in NICU might give an impression that the actual magnitudewill be low; even then this figure is so high that it is recommended to measure temperature in Labor ward for hypothermia as that will open a window of opportunity to intervene before it is late. A more practical and achievable first step would be to at least conduct a routine temperature measurement for all newborns in labor ward, which is not happening at the moment; and it is the recommendation of this study to implement this strategy as it will pave the way for a more wider look in to the case.