Postnatal thermal adaptation and the effects of seasonal variations on temperature trends leading to cold stress in newborn infants in rural India

Abstract

Background: Transitional adaptation of newborns delivered in controlled environments of developed countries has been studied extensively but there is a gap in knowledge regarding the thermal adaptation of the newborn immediately after birth delivered in resource poor conditions prevailing in developing countries. Objective: To observe the thermal adaptation of newborn infants by studying the temperature changes in central - abdominal skin temperature (Ta) and peripheral - sole of the foot temperature (Tf) in healthy term newborns in the delivery room and postnatal ward for the first 12 hours of life. Study Design: The study was conducted in KLE University Hospital, Belgaum, India, during the seasons (rainy and spring) that cause hypothermia due to the ambient conditions in these regions. The data was collected from two groups of infants - Group A (Rainy season) and Group B (Spring season) consisting of 20 and 31 infants respectively. The body temperature data was collected to observe variations at different locations of neonatal care in the hospital during the study period. Additionally the ambient temperature and humidity were also monitored to understand the prevailing conditions that the infants encounter. Result: Mean Ta was 35.9 ◦ C and 35.8 ◦ C in the delivery room in infants from Groups A and B, respectively. The major variations were observed around six hours of life. The mean Ta and Tf were 35.63 ◦ C and 30.38 ◦ C in Group A and 35.95 ◦ C and 32.51 ◦ C in Group B during this period. Conclusion: Healthy term infants are subjected to severe thermal stress during the first 12 hours of life in developing countries with no control over the environmental temperature in delivery room and postnatal ward that is also influenced by seasonal variation. These findings underscore the need to control the environmental temperature, ensure proper clothing and use of Kangaroo care to prevent hypothermia in healthy term infants.