Prevalence of hypothermia and associated factors among neonates admitted to special care nursery at Raleigh Fitkin Memorial hospital, Manzini, Eswatini.
Date
2025
Authors
Mabuza, Ncanele Nokukhanya
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
Neonatal hypothermia is an abnormal thermal state in which the neonate’s body temperature is less than 36.5 ̊ C. It remains a critical concern particularly in resource limited settings, contributing significantly to neonatal morbidity and mortality. While neonatal hypothermia is well documented globally, there is inadequate local data on its prevalence and contributing factors in Eswatini’s healthcare settings. This gap in knowledge limits targeted interventions for addressing hypothermia in the region. This study aimed to assess the prevalence of neonatal hypothermia and its associated factors among neonates admitted to the Special Care Nursery (SCN) of Raleigh Fitkin Memorial Hospital (RFMH) in Eswatini. A descriptive cross sectional study was conducted with 274 participants, consisting of 137 neonates and 137 mothers, admitted to the Special Care Nursery (SCN). Data were collected using a structured questionnaire and checklist, as well as through the medical records of the neonates. The body temperatures of the neonates were measured on admission and 24 hours post-admission. Data analysis was performed using SPSS version 26. Chi-square tests were applied to assess associations between categorical variables and hypothermia, with Fisher’s exact test used where necessary. Binary logistic regression analysis was used to identify independent variables significantly associated with neonatal hypothermia. The prevalence of neonatal hypothermia among the study participants was 69.3%. The analysis revealed several significant associations. Premature infants (28 – <37 weeks gestation) were more likely to be hypothermic compared to full-term infants (≥37 weeks gestation) (AOR = 3.34, p = 0.014). Additionally, delayed
initiation of breastfeeding (beyond the first hour post-delivery) was strongly associated with increased likelihood of hypothermia (AOR = 0.203, p < 0.001). Neonates not born at RFMH also had a higher risk of hypothermia (AOR = 0.096, p = 0.025), as did those with low Apgar scores (<7) (AOR = 0.222, p = 0.017). The study found a high prevalence of neonatal hypothermia (69.3%) in the SCN of Raleigh Fitkin Memorial Hospital, with key factors
including prematurity, delayed breastfeeding initiation, low Apgar scores, and environmental influences. These findings emphasize the need for targeted interventions, such as improved thermal protection, timely breastfeeding, enhanced neonatal care protocols and contributes to the limited local data on hypothermia, informing health policy and efforts to reduce neonatal mortality in Eswatini.
Key words: Prevalence, Neonatal hypothermia, associated factor
Description
Thesis of Master of Science in Neonatal Nursing.