From the Guidelines
Hypothermia in newborns is most commonly caused by a large surface area-to-volume ratio and increased evaporative fluid losses from the skin, making premature infants particularly vulnerable. The causes of hypothermia in newborns can be attributed to several factors, including:
- Large surface area relative to body mass
- Thin skin
- Limited fat stores
- Increased evaporative fluid losses from the skin
- Premature birth, as premature infants are at a higher risk of net heat loss due to their immature thermoregulation mechanisms 1
- Environmental factors, such as a cold delivery room or inadequate warming measures
According to the 2015 American Heart Association guidelines, it is recommended that the temperature of newly born nonasphyxiated infants be maintained between 36.5°C and 37.5°C after birth through admission and stabilization 1. Strategies to prevent hypothermia in newborns include:
- Skin-to-skin contact with the mother
- Covering the baby with a blanket
- Increasing the room temperature
- Using radiant warmers
- Placing the baby on an exothermic mattress
- Using warmed humidified resuscitation gases
- Placing a polyethylene cap on the baby's head
It is essential to monitor the baby's temperature closely and avoid hyperthermia, as it can also increase the risk of neonatal mortality and morbidity 1. If a newborn's temperature falls below 36.5°C, it is crucial to warm the baby immediately and seek medical attention if the temperature does not improve within 30 minutes or if it is below 36°C 1.
From the Research
Causes of Hypothermia in Newborns
- Hypothermia in newborns can be caused by a low temperature environment, physiological function, and many other factors 2
- Full-term and preterm infants are vulnerable to hypothermia due to their limited ability to produce heat and maintain normal body temperatures 3
- Cold stress in term infants can occur due to the role of the hypothalamus in heat production, causes of and ways to prevent heat loss, and establishment of a neutral thermal environment 4
Risk Factors
- Environmental exposure can lead to hypothermia in newborns 5, 6
- Preterm infants are at a higher risk of hypothermia due to their low birth weight and limited ability to regulate their body temperature 3
- Inadequate thermal care in the delivery room and during transportation to the neonatal intensive care unit (NICU) can contribute to hypothermia in newborns 2
Prevention and Management
- Maintaining normal body temperatures in the delivery room is crucial to prevent hypothermia in newborns 3
- Interventions such as slow rewarming, insulation, and active heating can help manage hypothermia in newborns 2, 5
- Rewarming should be done slowly and carefully to avoid rapid changes in body temperature 2