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Heat Loss Prevention for Preterm Infants in the Delivery Room

Journal of Perinatology volume 25, pages 304–308 (2005)Cite this article

Abstract

OBJECTIVE:

Preterm infants are prone to hypothermia immediately following birth. Among other factors, excessive evaporative heat loss and the relatively cool ambient temperature of the delivery room may be important contributors. Most infants <29 weeks gestation had temperatures <36.4°C on admission to our neonatal unit (NICU). Therefore we conducted a randomized, controlled trial to evaluate the effect of placing these infants in polyurethane bags in the delivery room to prevent heat loss and reduce the occurrence of hypothermia on admission to the NICU.

METHODS:

After parental consent was obtained, infants expected to be <29 weeks gestation were randomized to intervention or control groups just prior to their birth. Infants randomized to the intervention group were placed in polyurethane bags up to their necks immediately after delivery before being dried. They were then resuscitated per NRP guidelines, covered with warm blankets, and transported to the NICU, where the bags were removed and rectal temperatures were recorded. Control infants were resuscitated, covered with warm blankets, and transported without being placed in polyurethane bags. Delivery room temperatures were recorded so this potentially confounding variable could be assessed.

RESULTS:

Intervention patients were less likely than control patients to have temperature < 36.4°C on admission , 44 vs 70% (p<0.01) and the intervention group had a higher mean admission temperature, 36.5°C vs 36.0°C (p<0.003). This effect remained significant (p<0.0001) when delivery room temperature was controlled in analysis. Warmer delivery room temperatures (≥26°C) were associated with higher admission temperatures in both intervention and control infants, but only the subgroup of intervention patients born in warmer delivery rooms had a mean admission temperature >36.4°C.

CONCLUSIONS:

Placing infants <29 weeks gestation in polyurethane bags in the delivery room reduced the occurrence of hypothermia and increased their NICU admission temperatures. Maintaining warmer delivery rooms helped but was insufficient in preventing hypothermia in most of these vulnerable patients without the adjunctive use of the polyurethane bags.

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Acknowledgements

The authors would like to acknowledge the additional investigative team members, Carla Ahearn RNC, MSN, NNP and Marie Morton, RN. We would also like to acknowledge Diane Holditch-Davis, RN, PhD, and Alex Robertson, MD for their thoughtful review of the manuscript.

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Authors and Affiliations

  1. Children's Hospital, University Health Systems of Eastern Carolina and University of North Carolina, Chapel Hill, USA

    Robin B Knobel RNC, MSN, NNP

  2. Neonatal Medicine, Women's Hospital of Greensboro, Greensboro, NC, USA

    John E Wimmer Jr MD

  3. Department of Biostatistics, School of Allied Health Sciences, East Carolina University, USA

    Don Holbert PhD

Authors
  1. Robin B Knobel RNC, MSN, NNP
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  2. John E Wimmer Jr MD
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  3. Don Holbert PhD
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Corresponding author

Correspondence to John E Wimmer Jr MD.

Additional information

This research was partially supported by National Institute for Nursing Research T32 NR07091 Interventions to Prevent and Manage Chronic Illness.

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Knobel, R., Wimmer, J. & Holbert, D. Heat Loss Prevention for Preterm Infants in the Delivery Room. J Perinatol 25, 304–308 (2005). https://doi.org/10.1038/sj.jp.7211289

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