ADAPTIVE MECHANISMS IN TERM AND PRETERM NEONATES WITH HYPOTHERMIC SYNDROME: CLINICAL COURSE AND PATHOPHYSIOLOGICAL INSIGHTS
Keywords:
Neonatal hypothermia, Preterm infants, Term neonates, Thermoregulation, Adaptive mechanisms, Thermal care, Non-shivering thermogenesis, Physiological outcomes, Hypoglycemia, Temperature stabilization.Abstract
Background:
Neonatal hypothermia remains a major contributor to neonatal morbidity and mortality worldwide, particularly among preterm infants whose physiological mechanisms for thermoregulation are immature. According to World Health Organization, hypothermia is observed in up to 50% of hospitalized neonates in low- and middle-income countries and is strongly associated with respiratory distress, metabolic disturbances, sepsis, and increased mortality.
Objective:
To evaluate adaptive mechanisms, clinical course, and pathophysiological characteristics of term and preterm neonates with hypothermic syndrome and to compare thermoregulatory stabilization and physiological outcomes between these groups.
Methods:
A prospective comparative model-based study was conducted from 2025 to 2027 in the Neonatology Department of the Respublika ixtisoslashtirilgan ona va bola salomatligi ilmiy-amaliy tibbiyot markazi Buxoro viloyati filiali. A total of 100 neonates with hypothermic syndrome were included: 60 term and 40 preterm infants. Core temperature, heart rate, respiratory rate, oxygen saturation, blood glucose, and acid-base status were assessed at admission and after initiation of standardized thermal care. Statistical analysis was performed using SPSS; p<0.05 was considered significant.
Results:
Preterm neonates demonstrated significantly lower admission temperatures compared with term infants (34.1±0.5°C vs. 35.0±0.4°C, p<0.001). Time to achieve normothermia was longer in preterm neonates (6.2±1.1 hours vs. 3.8±0.9 hours, p<0.001). Hypoglycemia and respiratory instability were more frequent among preterm infants (p<0.05). Improvement in physiological parameters occurred in both groups following thermal intervention.
Conclusion:
Preterm neonates exhibit delayed and less efficient adaptive responses to hypothermia compared with term infants. Early identification and aggressive thermal management are essential to improve physiological stability and reduce complications.
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