Hypothermia in Extremely Low-Birth-Weight Infants After NICU Admission

To identify the clinical and procedural factors associated with hypothermia in extremely low-birth-weight (ELBW) infants in the NICU.

Retrospective cohort study using electronic medical record data.

Level IV NICU in South Korea.

The records of ELBW infants (N = 190) admitted to the NICU from January 2018 to December 2023.

We assessed hypothermia in infant records at NICU admission and 2 hours after NICU admission. We performed univariate and multivariable logistic regression analyses to identify clinical and procedural factors associated with hypothermia.

At admission to the NICU, records indicated that 47.9% (n = 91) of included infants had hypothermia, and 42.6% (n = 81) of the records indicated that included infants remained hypothermic at 2 hours after NICU admission. Gestational age was inversely associated with post-admission hypothermia (odds ratio (OR) = 0.77, 95% confidence interval (CI) [0.62, 0.95], p = .015). The records of infants who had endotracheal tubes or central lines that were repositioned indicated a greater risk of hypothermia (OR = 2.73, 95% CI [1.05, 7.11], p = .040).

We recommend active thermal management and minimal disruption during the early stabilization period to prevent hypothermia among ELBW infants and that neonatal nurses shift their focus from passive monitoring to active procedural stewardship in the NICU.