Independent statistician, Solagna, Italy.
Doctors with Africa CUAMM, Padova, Italy.
BMC Pregnancy Childbirth. 2020 Oct 23;20(1):646. doi: 10.1186/s12884-020-03343-7.
Thermal control after birth is an essential part of neonatal care. However, the relationship between neonatal temperature at and after admission is unknown. This study aimed to evaluate the change between neonatal temperature at admission and at day 1, and its impact on mortality.
Retrospective observational study at the Beira Central Hospital, Mozambique. Axillary temperatures were recorded at admission and at day 1 in 1,226 neonates who were admitted to the Special Care Unit between January 1 and December 31, 2017. The relationship between mortality rate and temperature change was evaluated with a matrix plot and a forest plot (obtained from a logistic regression model as odds ratios with 95% confidence intervals).
Normothermia was found in 415 neonates (33.8%) at admission and in 638 neonates (52.0%) at day 1. Mortality rate was highest in (i) neonates who remained in severe/moderate hypothermia (74%), (ii) neonates who rewarmed from hypothermia (40-55%), and (iii) neonates who chilled to severe/moderate hypothermia (38-43%). Multivariable analysis confirmed that temperature change from admission to day 1 was an independent predictor of mortality (p < 0.0001).
In a low-resource setting, one out of three neonates was found hypothermic at day 1 irrespectively of admission temperature. Relevant thermal deviations occurred in a high proportion of newborns with normothermia at admission. Being cold at admission and becoming cold or hyperthermic at day 1 were associated with increased likelihood of mortality. Appropriate actions to prevent both hypothermia and hyperthermia represent both a challenge and a priority during postnatal period.
出生后的体温控制是新生儿护理的重要组成部分。然而，新生儿入院时和入院后体温之间的关系尚不清楚。本研究旨在评估新生儿入院时和入院后第一天体温之间的变化及其对死亡率的影响。
这是莫桑比克贝拉中央医院的一项回顾性观察性研究。2017 年 1 月 1 日至 12 月 31 日期间，在特殊护理病房收治的 1226 名新生儿中，记录了腋温在入院时和入院后第一天的变化。死亡率与体温变化的关系采用矩阵图和森林图进行评估（从逻辑回归模型中获得，作为优势比和 95%置信区间）。
入院时体温正常的新生儿有 415 例（33.8%），入院后第一天体温正常的新生儿有 638 例（52.0%）。死亡率最高的情况为：（i）仍处于严重/中度低体温的新生儿（74%）；（ii）从低体温复温的新生儿（40-55%）；（iii）体温降至严重/中度低体温的新生儿（38-43%）。多变量分析证实，入院至入院后第一天的体温变化是死亡率的独立预测因素（p<0.0001）。
在资源匮乏的环境中，无论入院时的体温如何，有三分之一的新生儿在入院后第一天仍处于低体温状态。在入院时体温正常的新生儿中，存在明显的体温偏差。入院时体温过低以及入院后第一天体温过低或过高与死亡率增加相关。预防低体温和高热的适当措施是围生期的一个挑战和重点。
