Prevalence of neonatal hypothermia and its associated factors in East Africa: a systematic review and meta-analysis

Biruk Beletew,Ayelign Mengesha,Melese Abate,Mesfin Wudu

doi:10.1186/s12887-020-02024-w

Biruk Beletew, Ayelign Mengesha + Show 2 more

Open Access

https://doi.org/10.1186/s12887-020-02024-w

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Journal: BMC Pediatrics	Publication Date: Apr 3, 2020
Citations: 29	License type: open-access

Affiliation: Woldia University

Abstract

BackgroundNeonatal hypothermia is a global health problem and a major factor for neonatal morbidity and mortality, especially in low and middle-income countries. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of neonatal hypothermia and its associated factors in Eastern Africa.MethodsWe used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search electronic databases (PubMed, Cochrane Library and Google Scholar; date of last search: 15 October 2019) for studies reporting the prevalence and associated factors of neonatal hypothermia. The data was extracted in the excel sheet considering prevalence, and categories of associated factors reported. A weighted inverse variance random-effects model was used to estimate the magnitude and the effect size of factors associated with hypothermia. The subgroup analysis was done by country, year of publication, and study design.ResultsA total of 12 potential studies with 20,911 participants were used for the analysis. The pooled prevalence of neonatal hypothermia in East Africa was found to be 57.2% (95%CI; 39.5–75.0). Delay in initiation of breastfeeding (adjusted Odds Ratio(aOR) = 2.83; 95% CI: 1.40–4.26), having neonatal health problem (aOR = 2.68; 95% CI: 1.21–4.15), being low birth weight (aOR =2.16; 95%CI: 1.03–3.29), being preterm(aOR = 4.01; 95%CI: 3.02–5.00), and nighttime delivery (aOR = 4.01; 95% CI:3.02–5.00) were identified associated factors which significantly raises the risk of neonatal hypothermia.ConclusionsThe prevalence of neonatal hypothermia in Eastern Africa remains high. Delay in initiation of breastfeeding, having a neonatal health problem, being low birth weight, preterm, and nighttime delivery were identified associated factors that significantly raises the risk of neonatal hypothermia.

Highlights

Neonatal hypothermia is a global health problem and a major factor for neonatal morbidity and mortality, especially in low and middle-income countries
We identified factors that were significantly associated with neonatal hypothermia in Eastern Africa
This study showed that delay in initiation of breastfeeding, having neonatal health problems, neonate’s low birth weight, being preterm, and nighttime delivery was identified factors that significantly raise the risk of neonatal hypothermia

Summary

Introduction

Neonatal hypothermia is a global health problem and a major factor for neonatal morbidity and mortality, especially in low and middle-income countries. According to the World Health Organization (WHO), neonatal hypothermia is defined as a core body temperature < 36.5 °C or a skin temperature < 36 °C and is categorized into three levels of severity: mild or cold stress (core 36.0 to 36.4 °C), moderate (core 32.0 to 35.9 °C) and severe (core < 32 °C) [1, 2]. Newborn bathing within the first day after birth, poor socioeconomic status, pitiable kangaroo mother care practices, initiation of breastfeeding after 1 hour, massage of neonates with oil and insufficient health worker’s knowledge on thermal care were determinant factors for neonatal hypothermia [13, 14]

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