Environmental hyperthermia,a hidden risk factor of neonatal morbidity and mortality in Tesseney Community Hospital,Eritrea: A cross-sectional study

Abstract

Background

Hyperthermia related to heat stress appears to be a silent, high-risk condition in hot tropical climates. Less attention being paid even in hottest areas of the world. Threatening global warming will have profound impact in neonates in near future, and the aim of this study was to assess if there was a correlation between high environmental temperature and neonatal outcome.

Methods

The study was a retrospective, cross-sectional study on neonates admitted in Tesseney Hospital from 1^st January 2020 to 31^st December 2020. Data was extracted from the admission cards using a pretested questionnaire, and chi-square was used to identify characteristics associated with neonatal mortality.

Results

82 neonates were admitted to the hospital during the study period. A majority of the neonates had low birth weight (51%) and delivered at term (71%). Mode of delivery was via cesarean section in 15% of the neonates and 13% were home deliveries. During admission, 60% of the neonates had fever, 59 % were not able to breast feed, and 5% had convulsion. The majority of the neonatal admission and mortality were from May to August, the hottest months of the year. At univariate analysis, preterm delivery (COR: 3.62; 95% CI: 1.28–10.20, p-value 0.015) and home delivery (COR: 4.13; 95% CI: 1.11–15.30, p-value 0.034) had a significant association with neonatal mortality, while neonatal admission from May to August (COR: 1.95; 95% CI: 0.57–6.67 p-value 0.287) had increased risk of adverse neonatal outcome. At multivariate analysis, birth weight above 2.5 kg (AOR: 0.01; 95% CI: 0.00–0.66 p-value 0.031) and hospital stay above 72 h (AOR: 0.05; 95% CI: 0.00–0.59 p-value 0.012) had a significant association with neonatal survival.

Conclusion

Preterm delivery, home delivery, and low-birth weight had a significant association with neonatal mortality. The hottest months of the year were associated with increased admission rate and neonatal mortality. Maintaining safe room temperature during heat stress of a year is crucial for neonatal well-being, and further large prospective study addressing limitation of the study was crucial.