Factors associated with hypothermia within the first 6 hours of life in infants born at ≥340 weeks' gestation: a multivariable analysis

Laura Nguyen; Nicholas Mitsakakis; Ewa Sucha; Brigitte Lemyre; Sarah Linda Lawrence

doi:10.1186/s12887-022-03512-x

Factors associated with hypothermia within the first 6 hours of life in infants born at ≥34⁰ weeks' gestation: a multivariable analysis

BMC Pediatr. 2022 Jul 25;22(1):447. doi: 10.1186/s12887-022-03512-x.

Authors

Laura Nguyen¹, Nicholas Mitsakakis², Ewa Sucha², Brigitte Lemyre^{3

4}, Sarah Linda Lawrence^{5

6}

Affiliations

¹ Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, Ontario, Canada.
² Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, Ontario, Canada.
³ The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario, Canada.
⁴ Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, Ontario, K1H 8L1, Canada.
⁵ The Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario, Canada. sllawrence@cheo.on.ca.
⁶ Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, Ontario, K1H 8L1, Canada. sllawrence@cheo.on.ca.

Abstract

Background: Lack of appropriate temperature management has been associated with significant adverse outcomes in preterm and low birthweight neonates. There is a lack of similar investigations in the late preterm (34⁰-36⁶) and term (≥37⁰) neonate population. Our aim was to identify key risk factors as well as clinical outcomes associated with hypothermia in this population.

Methods: A retrospective chart review was conducted at the Ottawa Hospital including all eligible infants ≥34⁰ weeks' gestation over a one-month period in November 2020. Infant, maternal, and delivery room variables were collected, including prematurity, maternal temperature, delivery mode, birthweight, and premature rupture of membranes, as well as clinical outcomes such as NICU/SCN admission and length of stay. Regression models were generated, adjusted for covariates, and stepwise regression was performed.

Results: Four hundred forty infants were included in the analysis; 26.8% (118/440) were hypothermic within 6 hours of delivery. In the multivariable analysis, prematurity, low 5 minute Apgar score (< 7) or need for resuscitation, maternal hypertension, and absence of premature rupture of membranes > 18 hours or suspected maternal infection were significantly associated with hypothermia within 6 hours of delivery (p < 0.05). Multivariable analysis of clinical outcomes demonstrated a significant association between hypothermia within 6 hours of delivery and NICU/SCN admission (OR = 2.87; 95% CI 1.36, 6.04), need for respiratory support or diagnosis of respiratory distress syndrome (OR = 3.94; 95% CI 1.55, 10.50), and length of stay (exp(β) = 1.20; 95% bootstrap CI 1.04, 1.37).

Conclusions: Our results suggest there are similar factors associated with hypothermia in our study population of infants born at ≥34⁰ weeks' gestation compared to prior studies in preterm and low-birthweight infants. Furthermore, hypothermia is associated with higher risk of adverse outcomes, which highlights the need to prevent hypothermia in all newborns.

Keywords: Hypothermia; Morbidity; Multivariable analysis; Neonatal; Newborn; Risk factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Birth Weight
Female
Gestational Age
Humans
Hypothermia* / etiology
Hypothermia* / prevention & control
Infant
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases* / epidemiology
Pregnancy
Retrospective Studies