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Backrround Hypothermia is common in surgical patients admitted to intensive care units and may contribute to adverse outcomes.This study evaluates the impact of postoperative hypothermia on outcomes in neonates after cardiopulmonary bypass surgery.Methods We conducted a retrospective cohort study enrolling neonate who underwent congenital heart surgery at a tertiary hospital from 2015 to 2017.Normothermia was defined as core temperature ≥36℃ and hypothermia as ＜36℃ on admission to intensive care unit after surgery.Neonates with hypothermia received warm resuscitation using a preheated radiant warmer.After 3-hour active warming,core temperatures ≥36℃ was defined as transient hypothermia,and core temperatures ＜36℃ was defined as persistent hypothermia.Outcome measures included chest drainage,in-hospital mortality,reoperation for bleeding,mechanical ventilation duration,and length of hospital stay after surgery.Results 255 neonates were included for final analysis.Sixty neonates (23.5％) were included in the normothermia group,130 neonates (51％) in the transient hypothermia group and 65 neonates (25.5％) in the persistent hypothermia group.The mortality in the persistent hypothermia group (16.9％) was significantly higher than in the transient hypothermia group (3.1％)and the normothermia hypothermia group (5％) (P=0.001).Multivariable linear regression analysis demonstrated that persistent hypothermia group had more chest drainage compared to normothermia (adjusted β=12.79 mL/kg,95％ CI: 1.88 mL/kg to 23.69 mL/kg,P=0.022).Conclusions Early postoperative hypothermiais common in neonates undergoing cardiopulmonary bypass surgery.Persistent hypothermia,but not transient hypothermia,is associated with increased chest drainage and higher in-hospital mortality compared to normothermia.