Quality Improvement Intervention Lowers Hypothermia Rates in Preterm Infants in a Resource-Limited Setting.

BACKGROUND

Admission hypothermia significantly threatens preterm neonates, especially in resource-limited settings.

METHODS

A quality improvement (QI) initiative focusing on thermoregulation was implemented in a Brazilian NICU. We conducted a quasi-experimental pre-post study comparing preterm infants (< 1500 g or < 33 weeks gestation) admitted before (n = 63) and after (n = 88) the intervention. Primary outcome was hypothermia prevalence (< 36.5°C) within the first hour of life.

RESULTS

The QI intervention reduced hypothermia prevalence from 82.5% to 68.2% (crude PR = 0.83; 95% CI: 0.69-0.99; p = 0.047) and increased median admission temperature from 35.3°C to 35.8°C (p = 0.013). Post-intervention hypothermia was associated with increased mortality (PR = 3.27; 95% CI: 1.06-10.05; p = 0.017).

DISCUSSION: Implementing targeted QI measures improved thermal outcomes among preterm neonates in a resource-constrained NICU. Despite reductions, persistent hypothermia highlights the need for ongoing efforts to enhance neonatal care and survival.