Hypothermia may occur in neonates and is often under-recognized. Certain risk factors can help identify an infant who may be more likely to have a low body temperature, so that early intervention can be made. The authors are from the SMS Medical College in Jaipur, India.


Definition of neonatal: core body temperature < 36°C

Core Body Temperature

Level of Hypothermia

34 to 35.9°C


30 to 33.9°C


< 30°C



Risk factors for neonatal hypothermia:

(1) prematurity

(2) low birth weight

(3) birth asphyxia (and probably low Apgar scores)

(4) cold environment (influenced by the amount of covering vs exposed skin, and if the child is kept dry)

(5) septicemia

(6) hypoglycemia

(7) hypothyroidism

(8) CNS dysfunction

(9) drug-induced hypothermia

(10) DIC


Clinical signs and symptoms other than low body temperature (may reflect the predisposing process):

(1) lethargy

(2) refusal to feed

(3) coldness of the body to the touch

(4) pedal edema

(5) sclerema (patchy or generalized hardening of the subcutaneous fat)

(6) erythema

(7) jaundice

(8) hemorrhage, bleeding and/or DIC

(9) cyanosis

(10) apnea


Hypothermia may be associated with serious morbidity and mortality, depending on the underlying causes, the severity of the hypothermia, and the responsiveness of the child's caregivers.


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