Hypothermia on admission: a risk factor for death in newborns referred to the Pernambuco Institute of Mother and Child Health.
The objective of this study was to determine the mortality risk related to hypothermia at the moment of admission and other factors such as clinical and geographical related to the transportation of the newborns admitted to the Instituto Materno Infantil de Pernambuco IMIP from 8 March to 11 June 2000. A prospective study involving 320 newborns arriving from home or health centres was carried out. Babies that were dead on arrival or subsequently transferred to other units were excluded. The risk of death was determined according to exposure to hypothermia and other types of exposure, using logistical regression. The risk of death was higher (RR = 3.09; CI = 2.15-4.43) in the group exposed to moderate hypothermia (temperature between 32.5 degrees C and 35.99 degrees C) than in the non-exposed group (temperature equal to or greater than 36.00 degrees C). The relative risk of death was also higher for newborns with a weight of less than 2500 g, that were less than 1 day old, respiratory distress syndrome, premature babies or with congenital malformations, that had used oxygen and/or intravenous infusion during transit, that came from the interior and that had travelled more than 150 km. In the final result of the multivariate analysis, sepsis ('adjusted' RO = 6.23; 95% CI = 5.66-6.80), respiratory distress syndrome ('adjusted' RO = 5.28; 95% CI = 5.03-5.59), moderate hypothermia ('adjusted' RO = 3.49, 95% CI = 3.18-3.81), and distance undertaken greater than 50 km ('adjusted' RO = 2.39; 95% CI = 2.14-2.63) remained. Hypothermia on admission showed itself to be an important and independent risk factor for neonatal death.
Núcleo de Epidemiologia do IMIP, Instituto Materno Infantil de Pernambuco, Recife, Brazil. suzamota@uol.com.br
Suzana Maria
SM
da Mota Silveira
Maria Júlia
MJ
Gonçalves de Mello
Suely
S
de Arruda Vidal
Paulo Germano
PG
de Frias
Adriano
A
Cattaneo
D000367:Age Factors; D001724:Birth Weight; D001938:Brazil / Q000453:epidemiology; D002662:Child Health Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007035:Hypothermia / Q000175:diagnosis*; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis; D008297:Male; D010343:Patient Admission; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D014187:Transportation of Patients / Q000592:standards*