Neonatal Hypothermia

Neonatal hypothermia is a condition characterized by a low body temperature in newborns, often resulting from environmental exposure or underlying health conditions.

Epidemiology

• Neonates are particularly vulnerable to hypothermia due to their large body surface area and limited ability to regulate body temperature.
• Incidence varies depending on factors such as gestational age, birth weight, and environmental conditions.
• Preterm and low birth weight infants are at higher risk.

Causes

• Prematurity.
• Inadequate thermal protection in the delivery room or nursery.
• Lack of appropriate clothing or bedding.
• Excessive evaporative heat loss.
• Infection.

Pathogenesis

• Newborns have limited ability to generate heat due to a high surface area to volume ratio.
• Excessive heat loss occurs through conduction, convection, radiation, and evaporation.
• Physiological mechanisms for thermoregulation are immature.

Clinical Features

• Cool skin.
• Hypotonia.
• Poor feeding.
• Irritability.
• Tachypnea.

Complications

• Respiratory distress.
• Metabolic acidosis.
• Hypoglycemia.
• Bradycardia.
• Increased risk of sepsis.

Differential Diagnosis

Conditions to consider when diagnosing neonatal hypothermia:

Condition	Distinguishing Features
Hypoglycemia	Irritability, poor feeding, and tremors.
Sepsis	Fever, lethargy, and poor feeding.

Diagnosis

• Measurement of axillary or rectal temperature.
• Blood glucose monitoring.
• Assessment for signs of infection.

Treatment

• Gradual rewarming using radiant warmers or incubators.
• Skin-to-skin contact with the mother (kangaroo care).
• Warm intravenous fluids.
• Monitoring for and treating associated complications.

Prognosis

• Prognosis is generally good with prompt recognition and treatment.
• Long-term outcomes depend on the severity of hypothermia and associated complications.

Prevention

• Ensure adequate environmental temperature in delivery rooms and nurseries.
• Provide appropriate clothing and bedding for newborns.
• Promote skin-to-skin contact between mother and infant.
• Regular monitoring of newborns' temperature.