{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:58:31Z","timestamp":1776254311701,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":104,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Admission hypothermia significantly threatens preterm neonates, especially in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A quality improvement (QI) initiative focusing on thermoregulation was implemented in a Brazilian NICU. We conducted a quasi\u2010experimental pre\u2010post study comparing preterm infants (&lt;\u20091500\u2009g or\u2009&lt;\u200933\u2009weeks gestation) admitted before (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200963) and after (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200988) the intervention. Primary outcome was hypothermia prevalence (&lt;\u200936.5\u00b0C) within the first hour of life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The QI intervention reduced hypothermia prevalence from 82.5% to 68.2% (crude PR\u2009=\u20090.83; 95% CI: 0.69\u20130.99;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047) and increased median admission temperature from 35.3\u00b0C to 35.8\u00b0C (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). Post\u2010intervention hypothermia was associated with increased mortality (PR\u2009=\u20093.27; 95% CI: 1.06\u201310.05;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Implementing targeted QI measures improved thermal outcomes among preterm neonates in a resource\u2010constrained NICU. Despite reductions, persistent hypothermia highlights the need for ongoing efforts to enhance neonatal care and survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.70397","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:07:38Z","timestamp":1776251258000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality Improvement Intervention Lowers Hypothermia Rates in Preterm Infants in a Resource\u2010Limited Setting"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0442-1016","authenticated-orcid":false,"given":"Patrycia Maria Gomes","family":"da Fonte Rosa","sequence":"first","affiliation":[{"name":"Maternity Hospital\u2010School Janu\u00e1rio Cicco (MEJC)  Natal Rio Grande do Norte 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Services (EBSERH)  Natal Rio Grande do Norte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7085-8788","authenticated-orcid":false,"given":"Amaxsell Thiago Barros","family":"de Souza","sequence":"additional","affiliation":[{"name":"Federal University of Rio Grande Do Norte (UFRN)  Natal Rio Grande do Norte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3268-991X","authenticated-orcid":false,"given":"Camiliane Azevedo","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Maternity Hospital\u2010School Janu\u00e1rio Cicco (MEJC)  Natal Rio Grande do Norte Brazil"},{"name":"Brazilian Company of Hospital Services (EBSERH)  Natal Rio Grande do Norte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9717-7154","authenticated-orcid":false,"given":"Amanda Karoline","family":"da Costa Bezerra","sequence":"additional","affiliation":[{"name":"Federal University of Rio Grande Do Norte (UFRN)  Natal Rio Grande do Norte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5228-7707","authenticated-orcid":false,"given":"Raionara Cristina","family":"de Ara\u00fajo Santos","sequence":"additional","affiliation":[{"name":"Maternity Hospital\u2010School Janu\u00e1rio Cicco (MEJC)  Natal Rio Grande do Norte Brazil"},{"name":"Brazilian Company of Hospital Services (EBSERH)  Natal Rio Grande do Norte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9959-0252","authenticated-orcid":false,"given":"Cijara Leonice","family":"de Freitas","sequence":"additional","affiliation":[{"name":"Maternity Hospital\u2010School Janu\u00e1rio Cicco (MEJC)  Natal Rio Grande do Norte Brazil"},{"name":"Brazilian Company of Hospital Services (EBSERH)  Natal Rio Grande do Norte 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