Evaporative heat loss in the very low birthweight infant can be very great in the first minutes of life. We investigated the effects of wrapping the infant in a polyethylene bag immediately at birth (without drying) vs. conventional dry exposure on rectal temperature measured at subsequent nursery admission. Our null hypothesis was that there was no difference in admission temperature between infants resuscitated enclosed in bags vs. those experiencing conventional dry exposure.

METHOD: Imminent deliveries ≤ 31 weeks gestation were stratified by gestational age and randomly allocated to bag or no-bag resuscitation. All infants were resuscitated under radiant warmers in the delivery room. Bags were removed on admission to the nursery (mean age 13 mins). Rectal temperature was taken by electronic thermometer. Maternal temperature, delivery room and transfer-incubator temperatures, and time to admission were not different between groups.

RESULTS (table): 59 of 62 recruited infants completed the study. Occlusive wrapping caused a mean 1.9 deg C difference in admission temperatures of infants <27 weeks gestation only. All 5 deaths were in the no-bag group (vs. bagged, p=0.04); mean temperature was 35.1 °C, vs. 36.5 °C in survivors.

Table 1
Full size table

CONCLUSIONS: Occlusive wrapping of very low birth weight infants at delivery reduces postnatal fall in temperature. This may be reflected in decreased mortality.

Table is in means and (sd).

Funded by the IWK≈Grace Research Foundation