MORTALITY WITHIN THE FIRST 24 HOURS OF ADMISSION AMONG NEONATES AGED LESS THAN 24 HOURS IN A SPECIAL CARE BABY UNIT (SCBU) IN NIGERIA: THE ROLE OF SIGNIFICANT HYPOTHERMIA AND HYPOGLYCAEMIA

Background: Neonatal deaths mostly occur within the first week or the first 24 hours of life due to a variety of conditions. This study aimed to examine the role of significant hypothermia and hypoglycemia, in addition to a few other factors leading to neonatal mortality within the first 24 hours of admission. Methods: This prospective study was conducted on neonates hospitalized within the first 24 hours of life in a Special Care Baby Unit (SCBU) in Nigeria. The axillary temperature and serum glucose were consecutively recorded at admission. Through bivariate and multivariate analyses, hypothermia (axillary temperature 36 °C) and hypoglycemia (random blood glucose 40 mg/dL) were found to be associated with the risk of mortality within the first 24 hours of admission in neonates. Results: Out of 277 neonates, 24.2% and 27.3% had significant hypothermia and hypoglycemia, respectively. The overall mortality rate was 21.6% (49/227) while 38.8% (19/49) of the deaths occurred within the first 24 hours of admission. The Case Fatality Rate (CFR) was 41.2% among the neonates with co-existing significant hypothermia and hypoglycemia and 0.9% among neonates with neither of the conditions. Mortality within the first 24 hours of admission was significantly associated with hypoglycemia, significant hypothermia, asphyxia, and apnea, according to bivariate and multivariate analyses. Conclusion: Mortality within the first 24 hours of admission among the neonates admitted within the first 24 hours of life accounts for almost 40% of all neonatal deaths. In the present study, significant hypothermia and hypoglycemia were considered as the major independent contributors.