title: Hypothermia of newborns is associated with excess mortality in the first 2 months of life in Guinea-Bissau, West Africa.
abstract: OBJECTIVE
  To examine the long-term effects of neonatal hypothermia (HT) on survival.
  
  
  METHODS
  Using the longitudinal community and hospital surveillance system of the Bandim Health Project, we followed children born between 1997 and 2002 at the only maternity ward in the city. All children's axillary temperature was measured within 12 h of birth. They were followed from birth to 6 months of life through regular home visits.
  
  
  RESULTS
  We identified 2926 live births in the study area and 177 deaths before 6 months of age. Based on mortality risk, we defined a temperature below 34.5 degrees C as the cut-off point for HT. Two hundred and thirty-eight (8%) children had HT. Controlled for birth weight, HT was associated with a nearly fivefold increase in mortality during the first 7 days of life [mortality ratio (MR) = 4.81 (2.90-8.00)] and with increased mortality from 8 to 56 days of life [MR = 2.55 (1.29-5.04)].
  
  
  CONCLUSIONS
  HT is associated with excess mortality beyond the perinatal period up to at least 2 months of age, especially among low-birth-weight children. Hence, failure to comply with the WHO guidelines for care of newborns in low-income countries may have long-term consequences for child survival which have not previously been assessed. The WHO definition of HT should be based on mortality data.
authors.affiliation: Projécto de Saúde Bandim, Indepth Network, Bissau, Guinea-Bissau. mortenso@dadlnet.dk
authors.forename: Morten
authors.initials: M
authors.lastname: Sodemann
authors.forename: Jens
authors.initials: J
authors.lastname: Nielsen
authors.forename: Jens
authors.initials: J
authors.lastname: Veirum
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Jakobsen
authors.forename: Sidu
authors.initials: S
authors.lastname: Biai
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D003906:Developing Countries; D004812:Epidemiologic Methods; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D007035:Hypothermia / Q000453:epidemiology / Q000401:mortality*; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male