Objectives
The objective of this study is to find the easily measurable associated factor for hypothermic neonatal mortality in a regional Moroccan hospital.
Methods
A retrospective study was carried out in PAGNON hospital. 52 patients admitted to PAGNON hospital neonatal unit for hypothermia between October 1st, 2005, and June 30, 2007, were included in this study. Clinical features including gestational age, body weight at hospitalization, rectal temperature, the day after birth, place of delivery were recorded at the time of hospitalization. Hypothermia was classified as per WHO classification.
Results
In 52 hypothermic neonates, 36 patients (69.3%) survived and 16 patients (30.7%) died. There was a significant statistical difference between survival group and no survival group regarding rectal temperature (31.1±2.7°Cvs. 28.7±2.3°C; mean±SD, p=0.003). All patients who died during hospitalization had below 33°C of rectal temperature at hospitalization. As for WHO classification, the severe hypothermic group had higher mortality rate than the moderate hypothermic group (45.2% vs. 9.5%, p=0.006). There was no significant statistical difference for body weight at hospitalization, the day after birth and gestational age in two groups. The severe hypothermic group was higher in the ratio of delivery at the domicile than those of moderate hypothermic group (22.6% vs. 0%, p=0.020). In multiple logistic regression analysis accounting for rectal temperature, the day after birth and body weight at hospitalization, only rectal temperature was significantly associated with survival rate (odds ratio 1.408, 95% confidence interval 1.088−1.821, p=0.009).
Conclusion
Between the moderate hypothermic neonates and the severe hypothermic neonates classified WHO classification, there was a significant difference between the mortality rate. It is important to keep the rectal temperature more than 32°C. The rectal temperature is an associated factor for hypothermic neonatal mortality which is easily measured at hospitalization in rural hospital in morocco.