Prevalence and associated factors of neonatal hypothermia in the neonatal intensive care unit at St. Peter’s specialized Hospital, Ethiopia

Abstract Neonatal hypothermia, defined as a body temperature below 36.5 °C, is a global issue that significantly increases neonatal morbidity and mortality, particularly in low- and middle-income nations. Despite global guidelines, the prevalence remains high in many resource-limited settings. This study aimed to assess the prevalence and associated factors of hypothermia among neonates admitted to the intensive care unit of St. Peter’s Specialized Hospital. An institution-based cross-sectional study was conducted from July to September 2024 among 222 neonates admitted to the intensive care unit of St Peter’s Specialized Hospital. The data were collected using a semi-structured questionnaire and chart review. Binary and multivariate logistic regression analyses were used to identify factors associated with hypothermia at a significance level of p  < 0.05 using Statistical Package for Social Sciences (SPSS) version 25.0 software. Prevalence of neonatal hypothermia was 66.7%. Neonates from families earning ≤ $100 (AOR = 2.60, 95% CI: 1.25, 5.42), aged ≤ 24 h (AOR = 2.85, 95% CI: 1.85, 5.05), with a gestational age < 37 weeks (AOR = 4.50, 95% CI: 2.40, 6.50), with a lack of thermal care (AOR = 2.75, 95% CI: 1.50, 4.40), with improper wrapping at admission (AOR = 5.50, 95% CI: 3.60, 9.80), and with inborn delivery (AOR = 2.75, 95% CI: 1.45, 5.00) increased the odds of hypothermia. However, single pregnancy (AOR = 0.36, 95% CI: 0.15, 0.88) decreases the odds of hypothermia. Neonatal hypothermia remains highly prevalent among neonates admitted to the intensive care unit of St. Peter’s Specialized Hospital. Significant risk factors were low income, neonates aged ≤ 24 h, gestational age < 37 weeks, lack of thermal care, improper wrapping at admission, and inborn delivery. While a single pregnancy is a proactive factor. Adherence to thermal care practices guidelines, particularly during the first hours of life, is crucial. Healthcare facilities should enforce policies, provide regular training, and evaluate the effectiveness of national and World Health Organization guidelines.