McAbee Lauren, Mundagowa Paddington T, Agbinko-Djobalar Babbel, Gyebi Owusu Prince, Sackey Adziri, Sagoe-Moses Isabel, Sacks Emma, Sakyi Kwame Sarfo, Dail Robin B, Kanyangarara Mufaro
Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, United States of America.
Korle-Bu Teaching Hospital, Accra, Ghana.
PLOS Glob Public Health. 2023 Oct 24;3(10):e0001681. doi: 10.1371/journal.pgph.0001681. eCollection 2023.
Neonatal hypothermia poses an increased risk of infection, hypoglycemia, metabolic dysfunction, and mortality, particularly in preterm or low birthweight (LBW) infants. However, early detection of hypothermia and prompt thermoregulation can mitigate these effects thus, the need for continuous neonatal temperature monitoring. The BEMPU TempWatch is a small bracelet designed for continuous temperature monitoring for neonates. When the body temperature falls below 36.5˚C, the bracelet generates an alarm sound and flashes an orange light, indicating hypothermia. This study aimed to assess the validity of the BEMPU TempWatch in detecting hypothermia in a clinical setting in Ghana using sensitivity and specificity. Additionally, the study sought to identify factors associated with misclassification using logistic regression analysis. A standardized questionnaire collected information about the mother, pregnancy, delivery, and neonate. The BEMPU TempWatch was placed on the wrist of the neonate, and over a 24-hour follow-up period, a nurse took 4-hourly axillary temperature readings using a digital thermometer. Whenever the device's alarm sounded, a nurse immediately checked and recorded the axillary temperature, undertook necessary clinical actions, and rechecked after 30 minutes. Among the 249 neonates included in the study, 57.0% were female, 12.5% were extremely LBW, and 13.7% were extremely preterm. Based on 1,973 temperature readings, the sensitivity of the BEMPU TempWatch in detecting hypothermia was 67.8%, and the specificity was 95.9%. The sensitivity was lower among neonates being treated in incubators (58.4%) compared to those not (82.7%). Sensitivity was higher among neonates with LBW (1,500-2,500g) (73.5%) than very or extremely LBW neonates (<1,500g) (62.8%). The results showed that the BEMPU TempWatch had significantly fewer misclassifications among neonates who were not treated in an incubator, received only breastmilk, and were not born extremely preterm. Further studies are warranted to evaluate the effectiveness of the BEMPU TempWatch on neonatal health outcomes.
新生儿低体温会增加感染、低血糖、代谢功能障碍和死亡的风险，尤其是在早产儿或低出生体重（LBW）婴儿中。然而，早期发现低体温并及时进行体温调节可以减轻这些影响，因此需要持续监测新生儿体温。BEMPU TempWatch是一款专为新生儿连续体温监测设计的小手镯。当体温低于36.5˚C时，手镯会发出警报声并闪烁橙色灯光，提示低体温。本研究旨在通过敏感性和特异性评估BEMPU TempWatch在加纳临床环境中检测低体温的有效性。此外,该研究试图通过逻辑回归分析确定与错误分类相关的因素。一份标准化问卷收集了有关母亲、怀孕、分娩和新生儿的信息。将BEMPU TempWatch戴在新生儿手腕上，在24小时的随访期内，护士每4小时用数字温度计测量一次腋下温度。每当设备发出警报时，护士会立即检查并记录腋下温度，采取必要的临床措施，并在30分钟后再次检查。在纳入研究的249名新生儿中，57.0%为女性，12.5%为极低出生体重儿，13.7%为极早产儿。基于1973次体温读数，BEMPU TempWatch检测低体温的敏感性为67.8%，特异性为95.9%。与未使用 incubator 的新生儿（82.7%）相比，使用 incubator 治疗的新生儿的敏感性较低（58.4%）。低出生体重（15００-2500g）新生儿的敏感性（73.5%）高于极低或超低出生体重新生儿（<1500g）（62.8%）。结果表明，在未使用 incubator、仅接受母乳喂养且不是极早产的新生儿中，BEMPU TempWatch的错误分类明显较少。有必要进行进一步研究以评估BEMPU TempWatch对新生儿健康结局的有效性。
