Comparison of maternal and neonatal characteristics of neonates with dehydration fever and healthy infants

Background: dehydration fever is a common problem during the first week of life. This study aimed to compare the characteristics of neonates with fever due to dehydration and healthy infants. Methods: This cross-sectional study was performed on 324 neonates including 120 neonates with normal body temperature and 204 neonates with fever due to dehydration (hyperthermia) referred to Ghaem Hospital in Mashhad, Iran from 2017 to 2019, using a convenience sampling method and a researcher-made questionnaire. Infants presenting with elevated body temperature and having an axillary temperature above or equal to the rectal temperature and with no clinical or laboratory evidence of infection were considered as fever due to dehydration (case group). Infants who were referred for a routine examination or had jaundice but did not require treatment were considered as controls. Infant characteristic (neonatal age, sex, Apgar score, defecation frequency, the first defecation, breastfeeding frequency, urinary frequency, duration of feeding, birth weight, daily weight loss, daily weight loss percentage, lethargy, irritability, mucosal dryness, status fontanelles, hyperthermia, convulsion, apnea, decreased consciousness and  infant hospitalization) and maternal information (age, weight, parity, hospital stay, breast problems, mode of delivery, breastfeeding position, delayed breastfeeding, and pregnancy problems. The data were analyzed using Student’s t-test, Chi-square and SPSS software, version 20 (IBM SPSS, Armonk, NY, USA). Results: In dehydration fever of newborn, admission weight, frequency and duration of feeding, defecation frequency, maternal age were low, but time to first feeding were high (P<0.05). In fever of dehydration: restlessness, mucosal dryness, fontanel status, seizure, apnea, decreased consciousness, breastfeeding with traditional remedies, inappropriate breastfeeding position, lack of let-down reflex, delayed onset of lactation, breast problems and jaundice were more frequent. Conclusion: Infants with fever of dehydration were more likely to weight loss, delayed in first feeding, shorter feeding times and lower duration of feeding, higher sodium, urea, creatinine, and blood glucose levels. According to the results of this study, breast problems, inappropriate breastfeeding position, absence of reflux, delayed lactation, less frequent breastfeeding, consumption of breast milk with dextrose, manna, and clay tap were risk factors for dehydration fever.