{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:52:36Z","timestamp":1791942756057,"version":"4.3.4"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Thermoregulation is a key component of well-newborn care. There is limited epidemiologic data on hypothermia in late preterm and term infants admitted to the nursery. Expanding on these data is essential for advancing evidence-based care in a population that represents more than 3.5 million births per year in the US.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To examine the incidence and factors associated with hypothermia in otherwise healthy infants admitted to the newborn nursery following delivery.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n A retrospective cohort study using electronic health record data from May 1, 2015, to August 31, 2021, was conducted at a newborn nursery at a university-affiliated children\u2019s hospital. Participants included 23\u202f549 infants admitted to the newborn nursery, from which 321\u202f060 axillary and rectal temperature values were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Infant and maternal clinical and demographic factors.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Neonatal hypothermia was defined according to the World Health Organization threshold of temperature less than 36.5 \u00b0C. Hypothermia was further classified by severity (mild: single episode, temperature 36.0-36.4 \u00b0C; moderate\/severe: persistent or recurrent hypothermia and\/or temperature &amp;lt;36.0 \u00b0C) and timing (early: all hypothermic episodes occurred within the first 24 hours after birth; late: any episode extended beyond the first 24 hours).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 23\u202f549 included infants (male, 12 220 [51.9%]), 5.6% were late preterm (35-36 weeks\u2019 gestation) and 4.3% were low birth weight (\u22642500 g). The incidence of mild hypothermia was 17.1% and the incidence of moderate\/severe hypothermia was 4.6%. Late hypothermia occurred in 1.8% of infants. Lower birth weight and gestational age and Black and Asian maternal race and ethnicity had the highest adjusted odds across all classifications of hypothermia. The adjusted odds ratios of moderate\/severe hypothermia were 5.97 (95% CI 4.45-8.00) in infants with a birth weight less than or equal to 2500 vs 3001 to 3500 g, 3.17 (95% CI 2.24-4.49) in 35 week\u2019 vs 39 weeks\u2019 gestation, and 2.65 (95% CI 1.78-3.96) in infants born to Black mothers and 1.94 (95% CI 1.61-2.34) in infants born to Asian mothers vs non-Hispanic White mothers.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of infants in the inpatient nursery, hypothermia was common, and the incidence varied by hypothermia definition applied. Infants of lower gestational age and birth weight and those born to Black and Asian mothers carried the highest odds of hypothermia. These findings suggest that identifying biological, structural, and social determinants of hypothermia is essential for advancing evidence-based equitable thermoregulatory care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.31011","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T11:32:30Z","timestamp":1693308750000},"page":"e2331011","source":"Crossref","is-referenced-by-count":41,"title":["Incidence of Neonatal Hypothermia in the Newborn Nursery and Associated Factors"],"prefix":"10.1001","volume":"6","author":[{"given":"Rebecca","family":"Dang","sequence":"first","affiliation":[{"name":"Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisha I.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingjie","family":"Weng","sequence":"additional","affiliation":[{"name":"Quantitative Sciences Unit, Department of Medicine, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan R.","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University, Palo Alto, California"},{"name":"Division of Pediatric Critical Care, Department of Pediatrics, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry C.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, University of California, San Diego"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janelle","family":"Aby","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Frymoyer","sequence":"additional","affiliation":[{"name":"Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,8,29]]},"reference":[{"issue":"3","key":"zoi230895r2","doi-asserted-by":"publisher","first-page":"e643","DOI":"10.1542\/peds.2006-0943","article-title":"Admission temperature of low birth weight infants: predictors and associated morbidities.","volume":"119","author":"Laptook","year":"2007","journal-title":"Pediatrics"},{"issue":"2","key":"zoi230895r3","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.jpeds.2013.09.049","article-title":"Hypothermia and early neonatal mortality in preterm infants.","volume":"164","author":"de Almeida","year":"2014","journal-title":"J Pediatr"},{"key":"zoi230895r4","doi-asserted-by":"publisher","first-page":"S49","DOI":"10.1038\/jp.2010.177","article-title":"Hypothermia in very low birth weight infants: distribution, risk factors and outcomes.","volume":"31","author":"Miller","year":"2011","journal-title":"J Perinatol"},{"issue":"1","key":"zoi230895r5","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1080\/14767058.2019.1597043","article-title":"Antecedents and outcomes of hypothermia at admission to the neonatal intensive care unit.","volume":"34","author":"Elbaum","year":"2021","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"1","key":"zoi230895r6","first-page":"1","article-title":"Births: final data for 2021.","volume":"72","author":"Osterman","year":"2023","journal-title":"Natl Vital Stat Rep"},{"issue":"5","key":"zoi230895r7","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1542\/hpeds.2022-006931","article-title":"Characterization of birth hospitalizations in the United States.","volume":"13","author":"Ding","year":"2023","journal-title":"Hosp Pediatr"},{"issue":"3","key":"zoi230895r8","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1001\/archpediatrics.2008.556","article-title":"Routine assessment of temperature in healthy newborns: lack of evidence for its clinical utility.","volume":"163","author":"Jaffe","year":"2009","journal-title":"Arch Pediatr Adolesc Med"},{"key":"zoi230895r9","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.jpeds.2020.05.055","article-title":"Sustainability of a clinical examination-based approach for ascertainment of early-onset sepsis in late preterm and term neonates.","volume":"225","author":"Frymoyer","year":"2020","journal-title":"J Pediatr"},{"issue":"1","key":"zoi230895r10","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1186\/s12887-022-03512-x","article-title":"Factors associated with hypothermia within the first 6?hours of life in infants born at =34\u00b0?weeks\u2019 gestation: a multivariable analysis.","volume":"22","author":"Nguyen","year":"2022","journal-title":"BMC Pediatr"},{"key":"zoi230895r12","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3013427","article-title":"Neonatal hypothermia and associated factors among newborns admitted in the neonatal intensive care unit of Dessie Referral Hospital, Amhara Region, Northeast Ethiopia.","volume":"2020","author":"Yitayew","year":"2020","journal-title":"Int J Pediatr"},{"issue":"6","key":"zoi230895r13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0218020","article-title":"Prevalence and factors associated with neonatal hypothermia on admission to neonatal intensive care units in Southwest Ethiopia\u2014a cross-sectional study.","volume":"14","author":"Ukke","year":"2019","journal-title":"PLoS One"},{"issue":"12","key":"zoi230895r14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267868","article-title":"Risk factors for neonatal hypothermia at Arba Minch General Hospital, Ethiopia.","volume":"17","author":"Tessema","year":"2022","journal-title":"PLoS One"},{"issue":"2","key":"zoi230895r15","doi-asserted-by":"publisher","first-page":"e214","DOI":"10.1542\/peds.2009-0913","article-title":"New intrauterine growth curves based on United States data.","volume":"125","author":"Olsen","year":"2010","journal-title":"Pediatrics"},{"issue":"4","key":"zoi230895r16","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1001\/jamapediatrics.2016.4678","article-title":"A quantitative, risk-based approach to the management of neonatal early-onset sepsis.","volume":"171","author":"Kuzniewicz","year":"2017","journal-title":"JAMA Pediatr"},{"issue":"3","key":"zoi230895r17","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1093\/ije\/dyu029","article-title":"Estimating predicted probabilities from logistic regression: different methods correspond to different target populations.","volume":"43","author":"Muller","year":"2014","journal-title":"Int J Epidemiol"},{"issue":"4","key":"zoi230895r18","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1080\/00031305.1980.10483031","article-title":"Population marginal means in the linear model: an alternative to least squares means.","volume":"34","author":"Searle","year":"1980","journal-title":"Am Stat"},{"issue":"7","key":"zoi230895r20","doi-asserted-by":"publisher","first-page":"1760","DOI":"10.1038\/s41372-021-01073-y","article-title":"A quality improvement initiative to reduce hypothermia in a baby-friendly nursery\u2014our story of algorithms, K-cards, and key cards.","volume":"41","author":"Joseph","year":"2021","journal-title":"J Perinatol"},{"issue":"3","key":"zoi230895r21","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1214","article-title":"Quality-improvement effort to reduce hypothermia among high-risk infants on a mother-infant unit.","volume":"141","author":"Andrews","year":"2018","journal-title":"Pediatrics"},{"issue":"7","key":"zoi230895r22","doi-asserted-by":"publisher","first-page":"38","DOI":"10.7748\/paed.18.7.38.s28","article-title":"The neonatal energy triangle\u2014part2: thermoregulatory and respiratory adaption.","volume":"18","author":"Aylott","year":"2006","journal-title":"Paediatr Nurs"},{"issue":"1","key":"zoi230895r23","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1186\/s13052-020-0810-z","article-title":"Body temperature at nursery admission in a cohort of healthy newborn infants: results from an observational cross-sectional study.","volume":"46","author":"Merazzi","year":"2020","journal-title":"Ital J Pediatr"},{"issue":"6","key":"zoi230895r24","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1053\/j.semperi.2017.07.002","article-title":"Birth outcome racial disparities: a result of intersecting social and environmental factors.","volume":"41","author":"Burris","year":"2017","journal-title":"Semin Perinatol"},{"issue":"2","key":"zoi230895r25","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1111\/j.1552-6909.2006.00033.x","article-title":"Black non-Hispanic mothers\u2019 perceptions about the promotion of infant-feeding methods by nurses and physicians.","volume":"35","author":"Cricco-Lizza","year":"2006","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"issue":"10","key":"zoi230895r26","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1055\/s-00000009","article-title":"Maternal and neonatal nurse perceived value of kangaroo mother care and maternal care partnership in the neonatal intensive care unit.","volume":"30","author":"Hendricks-Mu\u00f1oz","year":"2013","journal-title":"Am J Perinatol"},{"issue":"3","key":"zoi230895r27","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1038\/s41372-020-0721-2","article-title":"Perinatal care experiences among racially and ethnically diverse mothers whose infants required a NICU stay.","volume":"41","author":"Glazer","year":"2021","journal-title":"J Perinatol"},{"key":"zoi230895r1","volume-title":"Maternal and Newborn Health\/Safe Motherhood Unit","year":"1997"},{"key":"zoi230895r11","unstructured":"STAnford Research Repository (STARR). STARR tools. Accessed February 10, 2021. https:\/\/med.stanford.edu\/starr-tools.html"},{"key":"zoi230895r19","unstructured":"Lenth? RV, Bolker? B, Buerkner? P, . emmeans: estimated marginal means, aka least-squares means. 2023; R package version 1.8.7. Accessed March 14, 2023. https:\/\/cran.r-project.org\/web\/packages\/emmeans\/index.html"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2808871\/dang_2023_oi_230895_1692735447.89429.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T21:33:28Z","timestamp":1729978408000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2808871"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,29]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.31011","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,29]]}}}