Download Knowledge of mothers on neonatal hypothermia

Art of Scientific Writing
Assignment 3
Review of literature
Submitted by:
Mrs. Renita Priya Dsouza
Asst. Professor
Paediatric Nursing
Yenepoya Nursing College, Yenepoya University
Submitted to:
Dr. Vinitha Ramanath Pai
Professor and Deputy Director MPhil & PhD Program
Yenepoya Medical College,
Yenepoya University
Submitted on: 04/07/2015
Review of literature
Research question of unpublished data:
A study to assess the knowledge of mothers regarding neonatal hypothermia in
postnatal wards of selected hospital at Mangalore with a view to prepare information
pamphlet
Objectives of the study
1. To assess the knowledge of mothers regarding neonatal hypothermia
2. To find the association between knowledge of mothers regarding neonatal
hypothermia and selected demographic variables
3. To develop information pamphlet regarding neonatal hypothermia
Introduction
The under-5 children’s mortality rate has been decreased continuously in the past 30
years in the worldwide. The under-5 mortality rate which was 110 per 1,000 in the year 1980
has come down to 60 per 1000 in the year 2009. The mortality rate of baby’s under 28 days
which is considered as neonatal death has also been reduced significantly. It was
approximately 4.6 million in 1990 and 3.1 to 3.6 million in 2009 which shows the significant
reduction.1
One of the most contributing factors of neonatal morbidity and mortality is neonatal
hypothermia. The countries with high burden of neonatal deaths neonatal hypothermia is
gaining importance and critical intervention during to prevent and manage hypothermia
considered significant. Thermal control is one of the essential components of newborn care
adopted by World health organization.2 But while considering the factors associated with
thermal care of newborns it greatly depends on the resources available. 3
Regardless of birth weight and gestation hypothermia is a very common problem in
newborn and it occurs in all types of environment even in the places of warm climate. The
mortality rate of the babies with hypothermia is double compared to the babies without
hypothermia and hypothermia is an important cause of morbidity too. The cornerstones of
management of hypothermia are prevention and early detection.4
Research design and methods:
A study was conducted in Iran between 2011 and March 2012 to ascertain whether the
10 steps of warm chain has become part of routine care of the newborn in the hospital.
During the study period 522 healthy full term neonates were recruited and body temperature
was assessed at regular interval at delivery room and at 1, 2 and 4 h of life. Premature labor,
prolonged rupture of membranes, hypertension, Apgar score less than 7 at 5 min, signs of
illness or congenital abnormality was excluded. Baby was dried immediately and was kept
with mother in the same bed.5
A cross sectional study conducted in Nepal to assess the knowledge regarding
neonatal baby care by administering the structured interview schedule.6 A Descriptive cross
sectional survey was also conducted in Trivandraum, India among mothers of 70 infants
attending OPDs and admitted in postnatal wards to assess the knowledge regarding newborn
care. Interviews were conducted with structured interview schedule.7
Results:
A study conducted in tertiary care setting in Nigeria showed that among the 41 neonates
studied, hypothermic events were commonly seen but it was not significantly associated with
the mortality. Most of neonates who rapidly reached hyperthermia after a prolonged
hypothermia survived and all Extremely low birth weight neonates who had prolonged
hyperthermia followed rapid hypothermia died within 8 hours.8 The knowledge deficit of
health workers and primary care givers might be an important factor which may affect the life
of a newborn and available simple and feasible interventions to prevent hypothermia need to
applied by them. 2 A review article done to provide an overview of the factors contributing to
neonatal hypothermia shows that the risk is high during the winter season, and physiological
factors are pertained to the newborn itself like prematurity, low birth weight and intrauterine
growth restriction. Non-evidence based practices, sometimes undertaken like bathing of the
newborn immediately after birth, and/or massaging the baby with essential oils after birth
might be the behavioural factors and the social factors include mainly young and
inexperienced others or multiparas who are minding many children, economically poor
family.9
A study conducted in Nepal found that as per WHO classification of hypothermia 84.5%
were hypothermic immediately after birth, 85.1 % at 1 hr after birth, 86.6% at 2 hr after
birth and 81.8% 4 hr after birth and there is a significant association between temperature of
the delivery room and neonatal hypothermia.4The risk of mortality of newborn due to
hypothermia increases with each degree decrease in body temperature and it was strongly
associated with temperatures below 35.0°C and the risk was higher among preterm infants
compared with full-term infants .Even though the risk exists throughout the 28 days it is more
during first 7 days.10
Knowledge of mothers on neonatal hypothermia
The study conducted in Nepal shows mother had adequate knowledge on
breastfeeding but knowledge was poor regarding umbilical cord care and most deficient
knowledge was found in neonatal hypothermia.5 The study conducted in Kerala, India found
even though they knew when to seek medical care for their newborn they had very poor
knowledge about neonatal convulsions and neonatal hypothermia.6 The study conducted in
Karnataka, India showed 56.66% mothers had average knowledge, 36.66% had poor
knowledge and 6.66% had good knowledge and post test scores after the planned teaching
programme all the mothers had good knowledge regarding neonatal hypothermia but after
they were educated on neonatal hypothermia there was a significant improvement in the
knowledge score.11
Conclusion:
The literature reviewed related to neonatal hypothermia as expected shows that neonatal
mortality rates are still high in the current advance world especially in the developing
countries with low resources. Neonatal hypothermia imparts a great burden on the mortality
rate of neonates and very much neglected. Mothers lack knowledge on neonatal hypothermia
but if educated regarding the same can make a significant difference in knowledge as well as
death rate of neonates. Even the health workers are having poor knowledge on neonatal
hypothermia; they should give more importance towards the maintenance of room
temperature at labour room as well as maintaining newborn’s temperature throughout
neonatal period.
References:
Lunze K, Bloom D E, Jamison DT , Hamer DH; The global burden of neonatal
hypothermia: systematic review of a major challenge for newborn survival. BMC
Medicine 2013, 11:24
1. World Health Organization. Mother-baby Package: Implementing Safe Motherhood
in Countries. World Health Organization: Geneva, 1994
2. Kumar V, Shearer J C, Kumar A, Darmstadt G L; Neonatal hypothermia in low
resource settings: a review. Journal of Perinatology (2009) 29, 401–412;
3. Gupta J; Knowledge, attitude and practices to hypothermia amongst nursing
professionals and mothers of neonates, Asian student Medical journal .Vol 1(1) 2010
4. Delavar MA, Akbarianrad Z, Mansouri MM,
Yahyapour M; Neonatal Hypothermia
and Associated Risk Factors at Baby Friendly Hospital in Babol, Iran, Annals of
Medical and Health Sciences Research 2014 Jul-Aug; 4(Suppl 2): S99–S103
5. Priyadarshanie M N, Pethiyagoda K; Mothers’ knowledge regarding neonatal baby
care, GSTF Journal of Nursing and health care. Vol.2 No.1, March 2015
6. Oommen A, Vats M;Mothers Awareness Regarding Danger Signs of Neonatal Illnesses
at a Selected Hospital in Trivandrum. International journal of nursing care Vol 1 no2.
2013 Pages 1-6
7. Amadi HO, Olateju EK, Alabi P, Kawuwa MB, Ibadin MO, Osibogun AO;
Neonatal hyperthermia and thermal stress in low- and middle-income countries: a
hidden cause of death in extremely low-birth weight neonates. Paediatr Int Child
Health. 2015 May 2
8. Vilinsky, Aliona; Sheridan, Ann Hypothermia in the newborn: An exploration of its
cause, effect and prevention. British Journal of Midwifery 08/2014; 22(8):557-562.
9. Mullany LC, Katz J, Khatry SK, LeClerq SC, Darmstad GL, Tielsch JM; Risk of
.
Mortality Associated With Neonatal Hypothermia in Southern Nepal Arch Pediatr
Adolesc Med. 2010;164(7):650-656
10. Bhandari UM , Kharde SN, Raddi SA; A Study to Evaluate the Effectiveness of
Planned Teaching Program on Knowledge of Mothers on Prevention of
Hypothermia among Newborns in Selected Hospitals of Belgaum, Karnataka.
South Asian Federation of Obstetrics and Gynecology, January-April 2010;2(1):8992