The Early Detection of Pyrexia in the Newborn

Abstract

A rectal temperature in excess of 99.4[degree] F. (37.4[degree] C.) is accepted as evidence of pyrexia in the newborn infant. Two series were studied. Series. A was a control series of 292 babies admitted to a lying-in ward over a period of 12 months, and Series B was a major series of 358 babies who developed pyrexia while in the special baby care unit of the same hospital during a nine-year period. Forty-seven of the infants died. Babies in both series were nursed in open cots without hot-water bottles or electric blankets. Pyrexia contributed to by dehydration or infection was recorded in 10 infants in the control series. Infection, stress of labor and/or delivery and dehydration were the most common contributory factors, in that order of frequency. Less common factors included retained blood, congenital anomalies, prematurity and jaundice. Deep infections were associated with fever of later onset, greater severity and longer duration than superficial infections. Pyrexia was a feature of 68% of infants with deep and 50% of infants with superficial infections. Among babies with non-infective postnatal intracranial disturbance the incidence of fever was higher in those with convulsions. Raised temperatures of less than 100[degree] F. (37.8[degree] C.) were more common than those above 100[degree] F. in the presence of dehydration.