Prevention of hypothermia at birth in preterm and/or low birthweight babies
Sübutlu məlumatların xülasələri
04.04.2018 • Sonuncu dəyişiklik 04.04.2018
Editors
Plastic wraps or bags, skin-to-skin care and transwarmer mattresses appear to be effective for preventing heat loss in preterm babies, leading to higher temperatures on admission to neonatal units and less hypothermia.
Comment: The quality of evidence is downgraded by study limitations (unclear blinding of outcome assessment).
A Cochrane review included 25 studies with a total of 2433 subjects.
Barriers to heat loss (18 studies)
- Plastic wraps or bags were effective in reducing heat losses in infants (table ). There was insufficient evidence to suggest that barriers reduce the risk of death within hospital stay or other major morbidities, with the exception of reducing risk of pulmonary haemorrhage.
Plastic wrap or bag compared with routine care in preterm and/or low birth weight infants
| Outcome | Relative effect
(95% CI) | Risk with routine care | Risk with intervention - plastic wrap or bag (95% CI) | No. of participants
(studies) Quality of evidence |
| Core body temperature (°C) on admission to NICU or up to 2 hours after birth | - | 34.80 to 36.2 | MD 0.58 higher
(0.50 higher to 0.66 higher) | 1633
(13) Moderate |
| Hypothermia on admission to NICU: core body temperature < 36.5°C or skin temperature < 36°C Study population | RR 0.67
(0.62 to 0.72) | 738 per 1000 | 495 per 1000
(458 to 531) | 1417
(10) Moderate |
| Hyperthermia on admission to NICU: core body temperature > 37.5°C | RR 3.91
(2.05 to 7.44) | 12 per 1000 | 46 per 1000
(24 to 87)
| 1523
(12) Moderate |
| Major brain injury (within hospital stay) | RR 0.78
(0.47 to 1.27) | 62 per 1000 | 49 per 1000
(29 to 79)
| 1100
(5) Moderate |
| Pulmonary haemorrhage (within hospital stay) | RR 0.60
(0.38 to 0.95) | 112 per 1000 | 67 per 1000
(43 to 106)
| 796 (1) Moderate |
| Mortality (death within hospital stay or at 6 months' corrected gestation) | RR 0.91
(0.73 to 1.15) | 168 per 1000 | 153 per 1000
(123 to 194)
| 1447
(10) Moderate |
External heat sources (2 studies)
- Skin-to-skin care was shown to be effective in reducing the risk of hypothermia when compared to conventional incubator care for infants 1200 to 2199 g birthweight (RR 0.09, 95% CI 0.01 to 0.64; NNT 2, 95% CI 1 to 4; 1 study, n=31). The transwarmer mattress significantly reduced the incidence of hypothermia on admission to NICU in very low birth weight infants (RR 0.30, 95% CI 0.11 to 0.83; NNT 2, 95% CI 1 to 4; 1 study, n=24).
Ədəbiyyat
- McCall EM, Alderdice F, Halliday HL et al. Interventions to prevent hypothermia at birth in preterm and/or low birth weight infants. Cochrane Database Syst Rev 2018;(2):CD004210.