Prevalence and factors associated with neonatal hypothermia: a cross-sectional study among healthy term neonates in a peri-urban hospital in Northern Ugand

Abstract

Background Neonatal hypothermia is highly prevalent even in warm tropical countries. Neonatal hypothermia increases the risk of morbidity and mortality. In Uganda, the prevalence of hypothermia is not known among healthy term neonates. Objective To determine the prevalence of neonatal hypothermia and the associated factors in Lira Regional Referral Hospital. Methods Hospital-based cross-sectional study was conducted in Northern Uganda. The interviewer-administered questionnaires and direct observations used to determine the initiation of warm-chain practices after delivery for 271 newborns. The axillary temperature of neonates was measured at intervals of 10 min, 30 min, one hour, and 2 h after birth. The multivariate binary logistic regression was done. The 95% confidence interval (CI) and p-value < 0.05 used to identify factors significantly associated with neonatal hypothermia. Results Neonatal hypothermia was 67.6% during the first two hours postnatal. Neonatal hypothermia was 64.5% at 10 min, 81% at 30 min, 76% at one hour and 49% at two hours postnatal. Hypothermia was significantly associated with low birth weight (Adjusted odds ratio (AOR) = 2.78; 95% CI: 1.01–7.62); male sex (AOR = 1.69; 95% CI: 1.04–3.33), not drying the newborn (AOR = 3.06, 95% CI: 1.64–5.72); no skin to skin contact within five minutes postnatal (AOR = 2.17, 95% CI: 1.15–4.10); and low maternal body temperature (AOR = 2.70, 95% CI: 1.49–4.76). Conclusions The prevalence of neonatal hypothermia was high in the first two hours. Neonates who were more likely to have hypothermia were male, not dried properly, low birth weight, no skin-to-skin contacts, and low maternal body temperature. Proper drying of the newborn and skin-to-skin contact can reduce the burden of neonatal hypothermia. There is a need to train the midwives on proper drying of the newborn, keeping the mother warm, and the importance of skin-to-skin contact in prevention of neonatal hypothermia among male and low birth neonates.

Description

Keywords

Neonatal hypothermia, Neonates, Warm chain practices, Skin to skin contact

Citation

Akao, M. G., Nalwadda, G., Epuitai, J., Ayebare, E., Ndeezi, G., Ratib, D., & Tumwine, J. K. (2025). Prevalence and factors associated with neonatal hypothermia: a cross-sectional study among healthy term neonates in a peri-urban hospital in Northern Uganda. BMC pediatrics, 25(1), 786. https://doi.org/10.1186/s12887-025-06123-4