Document Detail

Postnatal hypothermia and cold stress among newborn infants in Nepal monitored by continuous ambulatory recording.
MedLine Citation:
PMID:  8795355     Owner:  NLM     Status:  MEDLINE    
AIMS: To describe the pattern of hypothermia and cold stress after delivery among a normal neonatal population in Nepal; to provide practical advice for improving thermal care in a resource limited maternity hospital. METHODS: The principal government funded maternity hospital in Kathmandu, Nepal, with an annual delivery rate of 15,000 (constituting 40% of all Kathmandu Valley deliveries), severe resource limitations (annual budget Pounds 250,000), and a cold winter climate provided the setting. Thirty five healthy term neonates not requiring special care were enrolled for study within 90 minutes of birth. Continuous ambulatory temperature monitoring, using microthermistor skin probes for forehead and axilla, a flexible rectal probe, and a black ball probe placed next to the infant for ambient temperature, was carried out. All probes were connected to a compact battery powered Squirrel Memory Logger, giving a temperature reading to 0.2 degree C at five minute intervals for 24 hours. Severity and duration of hypothermia, using cutoff values of core temperature less than 36 degrees C, 34 degrees C, and 32 degrees C; and cold stress, using cutoff values of skin-core (forehead-axilla) temperature difference greater than 3 degrees C and 4 degrees C were the main outcome measures. RESULTS: Twenty four hour mean ambient temperatures were generally lower than the WHO recommended level of 25 degrees C (median 22.3 degrees C, range 15.1-27.5 degrees C). Postnatal hypothermia was prolonged, with axillary core temperatures only reaching 36 degrees C after a mean of 6.4 hours (range 0-21.1; SD 4.6). There was persistent and increasing cold stress over the first 24 hours with the core-skin (axillary-forehead) temperature gap exceeding 3 degrees C for more than half of the first 24 hours. CONCLUSIONS: Continuous ambulatory recording identifies weak links in the "warm chain" for neonates. The severity and duration of thermal problems was greater than expected even in a hospital setting where some of the WHO recommendations had already been implemented.
M Ellis; N Manandhar; U Shakya; D S Manandhar; A Fawdry; A M Costello
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  75     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  1996 Jul 
Date Detail:
Created Date:  1996-10-10     Completed Date:  1996-10-10     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  F42-5     Citation Subset:  AIM; IM    
Centre for International Child Health, Institute of Child Health, London.
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MeSH Terms
Body Temperature
Cold Temperature*
Hospitals, Maternity / economics
Hypothermia / diagnosis*,  therapy
Infant, Newborn
Monitoring, Ambulatory*
Stress, Physiological / diagnosis*,  therapy
Grant Support
//Wellcome Trust

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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