Golden hour of neonatal life: Need of the hour

Abstract

“Golden Hour” of neonatal life is defined as the first hour of post-natal life in both preterm and term neonates. This concept in neonatology has been adopted from adult trauma where the initial first hour of trauma management is considered as golden hour. The “Golden hour” concept includes practicing all the evidence based intervention for term and preterm neonates, in the initial sixty minutes of postnatal life for better long-term outcome. Although the current evidence supports the concept of golden hour in preterm and still there is no evidence seeking the benefit of golden hour approach in term neonates, but neonatologist around the globe feel the importance of golden hour concept equally in both preterm and term neonates. Initial first hour of neonatal life includes neonatal resuscitation, post-resuscitation care, transportation of sick newborn to neonatal intensive care unit, respiratory and cardiovascular support and initial course in nursery. The studies that evaluated the concept of golden hour in preterm neonates showed marked reduction in hypothermia, hypoglycemia, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). In this review article, we will discuss various components of neonatal care that are included in “Golden hour” of preterm and term neonatal care.

Smartphone-based prenatal education for parents with preterm birth risk factors

“…Studies show that evidence based care in the first postnatal hour reduces hypothermia, hypoglycemia, intraventricular hemorrhage, chronic lung disease and retinopathy of prematurity in preterm infants. 39 Other examples of decisions that improve preterm health outcomes include breast feeding and progesterone prophylaxis. 40,41,42,43 If pregnancy ultimately does result in preterm birth hospitalization, parents can also benefit from better understanding of periviability GA health outcomes, options and complexities of neonatal delivery room care, and awareness of expected parental role in medical decision making.…”

Single-centre prospective observational study on postdelivery room care

“…The First Golden Hour of Life is known to be a critical period in the care of preterm infants as many outcomedetermining procedures are taking place. 11 This prospective observational study gives a first closer insight in potentially outcome determining variables: duration of post-DR care, duration of disconnection from the ventilator and positioning of the infant. It also demonstrated that even within a single-centre, post-DR care procedures vary depending on birth weight and type of transport.…”

Golden Hours: An Approach to Postnatal Stabilization and Improving Outcomes

“…NRP guidelines recommend that the temperature of neonates be maintained between 36.5 and 37.5°C after birth through admission and stabilization [58]. Indeed, we have known since 1907 [59] that admission temperature of neonate is a strong predictor of mortality at all gestational ages [60,61]. Despite these recommendations, it is common for critically ill term and preterm infants to be hypothermic on admission to the NICU; roughly half of preterm infants in the EPICURE Study were admitted to the NICU with a temperature less than 36.5°C [62].…”