What is a significant risk factor for hypothermia in neonates?

In neonates, the inability to shiver is a significant risk factor for hypothermia because shivering thermogenesis, a process that generates heat through muscle activity, is not fully developed in newborns. Neonates rely primarily on non-shivering thermogenesis, which occurs in brown adipose tissue and is less effective in generating heat compared to shivering. As a result, when neonates are exposed to cold environments or other factors that cause temperature drop, they have a reduced capacity to regulate their body temperature effectively, putting them at a higher risk for hypothermia.

Other factors such as high fat reserves, large weight for age, and the development of adequate muscle mass don't contribute significantly to the risk of hypothermia in the same way. While having fat reserves can help provide some insulation, it is not a protective factor like shivering is for older children and adults. Therefore, the unique physiological characteristics of neonates, particularly their inability to shiver, underscore the severity of the risk for hypothermia in this vulnerable population.