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Rectal, Axillary or Skin Temperature in Newborns?

Giulia Placidi, Ilaria Merusi and Luigi Gagliardi

Background: Hypothermia in newborns is strongly associated with increased morbidity. Despite its importance, where and how temperature should be measured is not still clearly defined.

Aim: To compare sites and instruments for measuring temperature in newborns to estimate differences and limits of agreement.

Patients: Sample: 107 healthy term newborns. The temperature was measured in three different body sites (forehaed, axilla and rectum), using three different thermomethers.

Results: Mean ± DS rectal temperature was 36.9 ± 0.4°C, mean axillary temperature was 36.5 ± 0.4°C, mean skin temperature was 36.1 ± 0.4°C. The mean rectal-axillary temperature difference was 0.3 °C (limits of agreement -0.30 to 0.92); the mean axillary-skin difference was 0.35°C (limits of agreement -0.45 to 1.17); the rectal-skin difference was 0.67°C (limits of agreement -0.05 to 1.40). All the differences between methods are statistically significant. Infants born after a cesarean section had a slightly lower temperature than after vaginal delivery.

Conclusions: Observed values of temperature depend on site and type of thermometer used. Since the measure in different sites produces different results, it seems necessary to define an objective way to assess it. The core-peripheral temperature difference may detect a thermal stress.