Prevalence and Factors Associated with Neonatal Hypothermia in Sub-Saharan Africa: Systematic Review and Meta-Analysis

Abstract

<b>Background/Objectives</b>: Neonatal hypothermia remains a significant contributor to neonatal mortality and morbidity mainly in low and middle-income countries, such as those in sub-Saharan Africa. The objective of this systematic review and meta-analysis is to assess the prevalence of neonatal hypothermia and its risk factors in sub-Saharan Africa. <b>Methods</b>: The Preferred Reporting Items for Systematic Review and Meta-Analysis statement (PRISMA) guideline was used to search databases (PubMed, Scopus, Cocrane library and Google Scholar) for studies reporting both the prevalence and factors associated with neonatal hypothermia in sub-Saharan Africa. We have included cross-sectional, cohort and descriptive studies published between 1 June 2014 and 31 May 2024. The Joanna Briggs Institute (JBI) quality appraisal checklist was used for the appraisal of studies. Subgroup analysis was conducted by country, study design and population. A total of 21 articles with 12,803 participants from 9 countries were included in the analysis. <b>Results</b>: The pooled prevalence of neonatal hypothermia was 55.39% (95% CI: 48.52, 62.25). Preterm birth (odds ratio (OR): 3.49; 95% CI: 1.98-6.16), low birth weight (OR: 3.56; 95% CI: 2.36-5.39), no skin-to-skin contact (OR: 1.31; 95% CI: 0.55-3.13), lack of resuscitation (OR: 2.56; 95% CI: 1.75-3.76), delayed initiation of breast feeding (OR: 2.38; 95% CI: 1.57-3.61), admission during cold season (OR: 1.80; 95% CI: 1.33-2.44), home delivery (OR: 1.94; 95% CI: 1.51-2.50) and early bathing (OR: 3.03; 95% CI: 0.98-9.38) were the factors significantly associated with neonatal hypothermia. <b>Conclusions</b>: The observed high prevalence of hypothermia was associated with physiological, behavioral and environmental factors.