The Association between Hypothermia during Emergency Room Admission and Newborn Mortality at Dr. Moewardi Hospital


  • Dwi Hidayah Department of Child Health, Faculty of Medicine, Sebelas Maret University/ Dr. Moewardi General Hospital, Surakarta, Indonesia
  • Rinawati Rohsiswatmo Department of Child Health, Faculty of Medicine, Indonesia University/ Cipto Mangunkusomo, Jakarta, Indonesia
  • Yulidar Hafidh Department of Child Health, Faculty of Medicine, Sebelas Maret University/ Dr. Moewardi General Hospital, Surakarta, Indonesia



Background: Hypothermia in newborns continues to be a significant issue and a leading cause of morbidity and mortality. The incidence of hypothermia in referral newborns is still high during hospital admission.

Subjects and Method: This is a prospective cohort study conducted at Dr. Moewardi Hospital. Data collection was carried out on January 1, 2015, until March 31, 2015, for referred newborns. The dependent variable was mortality and the independent variables included gestational age, birth weight, sepsis, severe respiratory distress, and temperature at the time of admission at the ER. The chi-square test and logistic regression were used to analyze the data, with a cut-off value of p<0.05 cut off and a confidence interval of 95%.

Results: There were 56 newborn referrals, with 60.7% incidence of hypothermia and 19.6% inci­dence with mortality. From the chi-square analysis, the variable of gestational age and weight did not meet the requirements of multivariate analysis (p> 0.25). The multivariate logistic regression analysis revealed a non-significant association between severe respiratory distress and mortality in referred newborns (OR= 5.25; 95% CI= 0.89 to 30.82; p= 0.066). After performing multivariate logistic regression analysis to obtain controlled ORs, there was a significant relationship between newborn referrals mortality and temperature at the time of ER admission (OR= 8.75; 95% CI= 1.07 to 3.26; p= 0.047) and sepsis (OR= 6.25; 95% CI= 150 to 28.69; p= 0.012) with mortality of referred newborns.

Conclusion: The incidence of hypothermic referred newborns is high. Hypothermia during admission at the ER and sepsis are both associated with increased mortality in referred newborns.

Keywords: newborns, hypothermia, mortality.

Correspondence:Dwi Hidayah. Department of Child Health, Faculty of Medicine, Sebelas Maret University and Dr. Moewardi General Hospital, Jalan Kolonel Sutarto No.132, Surakarta 57126, Indonesia. Mobile: 08122623728 Email:

Author Biography

Dwi Hidayah, Department of Child Health, Faculty of Medicine, Sebelas Maret University/ Dr. Moewardi General Hospital, Surakarta, Indonesia

Department of Child Health, Universitas Sebelas Maret Medical School/Dr. Moewardi Hospital, Surakarta, Central Java


Christensson K, Bhat GJ, Eriksson B, Shilalukey-Ngoma MP, Sterky G (1995). The effect of routine hospital care on the health of hypothermic newborn infants in Zambia. J Trop Pediatr. 41(4):210-4. doi: 10.1093/tropej/41.4.210.

Daga AS, Daga SR, Patole SK (1991). Determinants of Death Among Admissions to Intensive Care Unit for Newborns. J Trop Pediatr. 37(2):53–56.

Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, Bernis Ld (2005). Evidence-based, cost-effective internentions: how many newborn babies can we save?. Lancet. 88(2):977.

Holt J, Fagerli I (1999). Air transport of the sick newborn infant: audit from a sparsely populated county in Norway. Acta Paediatrica. 88(1):66–71. doi. org/10.1080/08035259950170637.

Ferrara A, Atakent Y (1986). Neonatal stabilization score. A quantitative method of auditing medical care in transported newborns weighing less than 1,000 g at birth. Medical care. 24(2):179–87. PMID: 3945136

Hammarlund K, Sedin G (2008). Transdermal Water Loaa in Newborn Infants. Acta Paediatrica, 68(6):795–801.

Hidayah D, Hafidh Y (2014). Risk factors for neonatal mortality at Moewardi Hospital, Surakarta. Paediatrica Indonesiana. 54(4):219.

Kementerian Kesehatan RI (2015). Modul pelatihan resusitasi, stabilisasi, dan transportasi bayi baru lahir di Puskesmas (Resuscitation, stabilization and transport training modules for newborns at the Puskesmas). Jakarta: Kementerian Kesehatan RI Direktorat Jenderal Bina Gizi dan KIA.

Kumar R, Aggarwal AK (1998). Body temperatures of home delivered newborns in north India. Tropical doctor. 28(3): 134–6.

Kumar V, Shearer JC, Kumar A, Darmstadt GL (2009). Neonatal hypothermia in low resource settings:a reviewo Title. Journal of perinatology. 29(1):401–12.

Lunze K, Bloom DE, Jamison DT, Harmer DH (2003). The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC Medicine. 11(29):11.

Madiyono B, Moeslichan S, Sastroasmoro S, Budiman I (2002). Perkiraan besar sampel (Estimated sample size). In: Sastroasmoro S, Ismael S, penyunting. Dasar-dasar metodologi penelitian. 1st Ed . Jakarta: CV Sagung Seto.

Silveira SM, Mello MJG, Vidal SA, Frieas PG, Cattaneo A (2003). Hypothermia on Admission: a Risk Factor for Death in Newborns Referred to the Pernambuco Institute of Mother and Child Health. J Trop Pediatr. 49(2):115–120.

Mullany LC, Katz J, Khatry SK, Leclerq SC, Darmstadt GL, Tielsch JM (2010). Risk of mortality associated with neonatal hypotermia in Southern Nepal. Arch Pediatr Adolesc Med 56(4):650. doi: 10.1001/archpediatrics.2010.103

Virgiansari D (2011). Hubungan antara hipoglikemi dengan kejadian hipotermia pada neonatus rujukan di RSUD Dr. Moewardi (The relationship between hypoglycemia and the incidence of hypothermia in referral neonates at RSUD Dr. Moewardi)

WHO (1997). Esential newborn care and breastfeeding: an instructional workshop.

Yunanto A (2014) Termoregulasi. Dalam: Khosim MS, Yunanto A, Dewi R, Sarosa G, Usman A, penyunting. Buku Ajar Neonatologi Edisi Pertama. 1st Ed. Jakarta: Ikatan Dokter Anak Indonesia.

Niswade A, Zodpey SP, Ughade S, Bangdiwala SI (2011). Neonatal morbidity and mortality in tribal and rural communities in Central India. Indian Journal of Community Medicine. 36(2):150.




How to Cite

Hidayah, D., Rohsiswatmo, R., & Hafidh, Y. (2023). The Association between Hypothermia during Emergency Room Admission and Newborn Mortality at Dr. Moewardi Hospital. Journal of Maternal and Child Health, 8(4), 440–447.