Assessment of admission hypothermia as a marker of neonatal death in neonates admitted to neonatal intensive care unit of hawassa referral hospital, Ethiopia
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Date
2018-06
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Addis Ababa Universty
Abstract
Background: It has been more than a century since the world recognized the necessity of warm environment for the care of the newborn unless which may lead to morbidity and mortality of the neonate. Even though there is change in the trend of neonatal mortality both globally and nationally, the change is not as such significant as child mortality that may tackle the achievement of global and national goal of reducing neonatal mortality. Studying the effect of hypothermia on neonatal death will help to provide an evidence for further clinical trials and programs that focus on revising management guideline in Neonatal Intensive Care Unit.
Methods Retrospective cohort study was conducted in Hawassa Referral Hospital. The study population was neonates who were admitted to Neonatal Intensive Care Unit and the study participants were selected by using simple random sampling technique from the record of neonates. Total sample size was determined to be 1062 and their records were reviewed. Proportional hazard assumption was checked, death rate was estimated, life table, Kaplan Meir survival curve and cox regression was used to estimate Hazard ratio. Statistical significance was declared by p value < 0.05.
Result: Out of 1010 (505 Hypothermic and 505 Normothermic) neonates 244 (24.16%) of them died and 766 (75.84%) were censored. Total follow up time was 4922 days for hypothermic and 4666 days for normothermic neonates. Death rate was 31 and 20 per 1000 neonates per day for hypothermic and normothermic neonates respectively. There was a significant difference in survival function between the two groups. Hypothermic neonates were 37% (AHR 1.37; CI 1.03, 1.82) more likely to die as compared to normothermic neonates. Clinical problems; respiratory distress (AHR 1.68; CI 1.22, 2.32), perinatal asphyxia (AHR 1.72; CI 1.12, 2.64) and congenital malformation (AHR 1.75; CI 1.22, 2.52) were statistically significant covariates for neonatal death.
Conclusion and Recommendation: Death rate in hypothermic neonates was significantly higher than normothermic neonates. Neonatal temperature should be monitored regularly and management for hypothermia needs evaluation, which should be supported by studies at community setting.
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Keywords
Admission hypothermia, Neonatal death, Survival, Neonatal Intensive Care Unit