Admission Hypothermia and Neonatal Mortality in the Ethiopian Neonatal Network

Abstract

Background: Admission hypothermia remains a problem in low-income countries. Methods: This cross-sectional study evaluated the association between admission hypothermia (<36.5°C) and neonatal mortality for newborns discharged from neonatal units at 20 Ethiopian hospitals in 2021. Results: Among 12 363 newborns, 51.6% were admitted with hypothermia. Predictors for hypothermia and mortality included multiple birth, low birth weight, lower gestational age, and congenital anomalies. In a multivariable analysis, risk for mortality increased for infants admitted at <33.9°C [aRR 2.39 (95% CI: 1.66, 3.45)], 34.0°C to 34.9°C [aRR 2.45 (95% CI: 1.88, 3.20)], 35.0°C to 35.9°C [aRR 2.00 (95% CI: 1.46, 2.74)], and 36.0°C to 36.4°C [aRR 1.59 (95% CI: 1.24, 2.04)], compared to infants admitted at 36.5°C to 37.5°C. Conclusions: Admission hypothermia was associated with a twofold increased risk of death. To address hypothermia, basic essential newborn care, proper warm intra-facility transportation, improved infrastructure and equipment, and skin-to-skin care should be prioritized.