Neonatal Hypothermia and Associated Risk Factors at Baby Friendly Hospital in Babol, Iran

BACKGROUND Thermal care is an important element of Baby Friendly Hospital. AIM The objective of this study was to determine the prevalence of neonatal hypothermia and associated risk factors in healthy full term newborns at a Baby Friendly Hospital. SUBJECTS AND METHODS A cross-sectional, descriptive study was conducted on consecutively healthy full term neonates recruited during a 1 year. Temperatures were recorded immediately after birth and at the age of 1, 2 and 4 h after birth in order to estimate the prevalence of neonatal hypothermia, defined as axillary temperature less than 36.0°C. The data were collected using an especially questionnaire; data of history of abortion, parity, mode of vaginal delivery, gestational age, birth weight, newborn temperatures, time of the first skin-to-skin contact, time of first breast feeding, first wrapping and first visiting by the pediatrician. Association between neonatal hypothermia and risk factors was determined using logistic regression. RESULTS Axillary temperature showed 41.2%, 47.5%, 46.4% and 37.2% of the a consecutive number of 522 healthy full term neonates were moderately hypothermia immediately after birth, at 1 h, 2 h and 4 h respectively. Spontaneous labor and warming room were associated with decreased risk of hypothermia. A persistently high prevalence of neonatal hypothermia was shown within the first 4 h of vaginal birth. All analyses were carried out using the SPSS version 17.0 (Chicago IL, USA). Test of the associations were done, stepwise multiple logistic regressions. Odds ratios (ORs) were assessed using maximum likelihood and associated 95% confidence intervals were computed. A P ≤ 0.05 was considered to be statistically significant. CONCLUSION The findings of this study indicated that a high prevalence of neonatal hypothermia was identified among healthy full term newborn in a Baby Friendly Hospital Initiative. Therefore, it is necessary to emphasize on the development "warm chain" in preventing neonatal hypothermia in Baby Friendly Hospital.